Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote RN Utilization Management Consultant

CVS Health

CVS Health in the United States seeks an RN Utilisation Management Nurse Consultant to support Medicare joint procedures in a remote, full-time role. Remote work with some evenings/holidays as required; strong collaboration with cross-functional teams.

You will review clinical data for precertifications, apply evidence-based criteria, coordinate care with providers, and help optimise utilization while upholding safety and quality.

#J-18808-Ljbffr
Vacancy posted 8 hours ago
Similar jobs that could be interesting for youBased on the Remote RN Utilization Management Consultant in Hydaburg, AK vacancy
  •  ...Health is seeking an experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on Medicare joint procedures. You will...  ...care and utilization. The position requires 3+ years RN experience, an active RN license, an associate degree in... 
    Remote work

    CVS Health

    United States
    2 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to work remotely on a full-time weekend schedule after training. This role focuses on ensuring members receive the right care at the right time by reviewing clinical information... 
    Remote work
    Full time
    Work at office
    Weekend work
    Day shift

    CVS Health

    United States
    2 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations and care coordination. This remote, full-time role requires an active RN license and 3+ years of nursing experience, including Med/Surg.... 
    Remote work
    Full time
    Work at office
    Shift work
    Weekend work
    Afternoon shift

    CVS Health

    Guin, AL
    3 days ago
  •  ...CVS Health is seeking an Utilization Management Nurse Consultant to assess, plan, implement, coordinate, monitor...  ...members. This role requires a skilled RN with experience in acute/critical...  ...and utilization management, offering remote work in California and a full-time schedule... 
    Remote work
    Full time
    Afternoon shift

    CVS Health

    Sacramento, CA
    3 days ago
  •  ...CVS Health is seeking an experienced Utilization Management Nurse Consultant (RN) to remotely review authorizations and assess medical necessity across multiple specialties. You will collaborate with care teams to ensure compliant, evidence-based reviews and timely decisions... 
    Remote work

    CVS Health

    United States
    1 day ago
  •  ...CVS Health is seeking a Registered Nurse for Utilization Management in a fully remote role. You will review clinical information, coordinate with care teams...  ...and care plans from home. Requires an active RN license and 2+ years in adult acute, critical care or medical... 
    Remote work

    CVS Health

    New York, NY
    2 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote Utilization Management team. This full-time role focuses on ensuring appropriate care coverage and optimizing member outcomes within a 4‑day weekend schedule... 
    Remote work
    Full time
    Weekend work

    4062 Aetna Resources, LLC

    United States
    4 days ago
  •  ...CVS Health is hiring a Utilization Management Nurse Consultant (Clinical Precertification RN, Medicare) for a remote, full-time weekday role. You will review clinical cases, determine coverage decisions and coordinate care with providers to ensure appropriate treatment... 
    Remote work
    Full time
    Work at office
    Home office
    Weekday work

    CVS Health

    Lincoln, NE
    8 hours ago
  •  ...CVS Health is seeking a Remote Utilization Management Nurse Consultant (RN) to review and determine appropriate coverage, applying policies and clinical guidelines. The role collaborates with care teams to coordinate treatment and improve member outcomes in a 4-day weekend... 
    Remote work
    Weekend work

    CVS Health

    United States
    3 days ago
  •  ...CVS Health Corporation is seeking an experienced Utilization Management Nurse Consultant (RN) to support remote concurrent review. You will review authorization requests, determine medical necessity, and apply clinical criteria to inform denials or approvals while collaborating... 
    Remote work

    CVS Health

    Austin, TX
    4 days ago
  •  ...CVS Health is seeking an experienced RN for a fully remote Precertification Nurse role within Utilization Management. Virginia residents are preferred, with a compact RN license and at least 3 years of nursing experience. You will review requests, gather documentation... 
    Remote work

    CVS Health

    Richmond, VA
    5 days ago
  •  ...CVS Health is seeking a Registered Nurse for Utilization Management to assess and coordinate healthcare services for members, applying clinical...  ...HIPAA compliance, and effective communication in a full-time, remote setup requiring residency in Colorado; strong computer... 
    Remote work
    Full time

    Colorado Psychiatric

    Denver, CO
    3 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join a remote, full-time role with a weekend schedule. You will review clinical data to support coverage determinations, apply guidelines, and coordinate patient care with... 
    Remote work
    Full time
    Weekend work

    CVS Health

    Raleigh, NC
    5 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) for a remote, full-time role with a weekend schedule. The RN will review clinical data to support coverage determinations, apply guidelines, and coordinate care with providers... 
    Remote work
    Full time
    Work at office
    Weekend work

    CVS Health

    Clayton, MO
    3 days ago
  •  ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote team. You will review clinical information to determine appropriate coverage and apply guidelines to support sound medical decisions while coordinating with... 
    Remote work
    Work at office
    Shift work
    Weekend work

    CVS Health

    El Paso, TX
    4 hours ago
  •  ...CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans and ensure appropriate... 
    Remote work

    CVS Health

    Alton, IL
    1 day ago
  •  ...with providers to facilitate care and treatment. You will identify referral opportunities to integrate CVS Health products and programs and serve as a clinical resource to internal and external stakeholders in utilization/benefit management. #J-18808-Ljbffr CVS Health
    Remote job

    CVS Health

    Annapolis, MD
    2 days ago
  • CVS Health is seeking an experienced Utilization Management RN to join our remote team. You will review authorization requests, assess medical necessity, and apply clinical criteria to determine appropriate care while maintaining compliance with health plan requirements... 
    Remote job

    CVS Health

    Bastrop, LA
    2 days ago
  • CVS Health is seeking an experienced Registered Nurse for Utilization Management in a full-time, remote-capable role based in California. The position supports 24/7 operations including weekends and evenings, with a focus on coordinating care and benefits for members. Responsibilities... 
    Remote job
    Full time
    Afternoon shift

    4062 Aetna Resources, LLC

    Sacramento, CA
    3 days ago
  •  ...seeking an experienced Registered Nurse for a full-time remote role in Ohio. The RN will assess, plan, implement, coordinate, monitor and...  ...with providers to facilitate care while aligning with utilization management goals. The position requires an active RN license, 2+... 
    Remote job
    Full time
    Weekend work
    Afternoon shift

    CVS Health

    Columbus, OH
    2 days ago
  • CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations from a remote location. The role requires strong clinical judgment, collaboration with care teams, and a weekend-oriented schedule after training... 
    Remote job
    Full time
    Weekend work

    CVS Health

    Central City, CO
    4 days ago
  • CVS Health in Columbus, OH seeks a Registered Nurse for Utilization Management to assess, plan, implement and coordinate healthcare services for...  ...care. Requires 2+ years in adult acute/critical care, an active RN license in the resident state, and flexibility for evenings,... 
    Remote job
    Weekend work
    Afternoon shift

    CVS Health

    Columbus, OH
    2 days ago
  •  ...CVS Health is hiring for an Utilization Management Nurse Consultant (RN) for remote work. The role focuses on concurrent review and ensuring timely, cost-effective care through evidence-based decision-making. Candidates need active RN licensure, multi-state capability... 
    Remote work

    4004 Aetna Medicaid Administrators

    United States
    5 days ago
  •  ...CVS Health is seeking an Utilization Management Nurse Consultant to ensure Medicare members receive appropriate care. This is a remote, full-time role with a weekday schedule and a base hourly...  ...care teams. Ideal candidates hold an RN license, have 3+ years of RN experience... 
    Remote work
    Hourly pay
    Full time
    Weekday work

    CVS Health

    Sioux Center, IA
    8 hours ago
  •  ...CVS Health is seeking a Utilization Management Nurse Consultant for a remote Texas position. The role uses clinical nursing experience to assess, plan, implement...  .../critical care, plus managed care exposure. Active RN license in home state is required; position includes... 
    Remote work
    Afternoon shift

    CVS Health

    United States
    2 days ago
  •  ...CVS Health is seeking a remote Utilization Management Nurse Consultant (Medicare) to apply clinical expertise beyond the bedside and ensure members receive...  ...guidelines to support coverage determinations. A 3+ year RN background including Med/Surg and an active RN license... 
    Remote work
    Full time
    Local area
    Monday to Friday
    Afternoon shift

    CVS Health

    United States
    4 days ago
  • $29.1 - $62.32 per hour

     ...bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) Remote | Full-Time | Monday-Friday Are you a Registered Nurse looking to leverage your... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area
    Work from home
    Monday to Friday
    Afternoon shift

    CVS Health

    Las Vegas, NV
    4 days ago
  • $26.01 - $56.14 per hour

     ...:00pm EST Location: 100% Remote (U.S. only) About Us American...  ...URAC-accredited medical management organization founded in 1...  ...medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical...  ...Qualifications Active, unrestricted RN license in your state of... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Local area
    Monday to Friday
    Flexible hours
    Shift work

    CVS Health

    Remote
    1 day ago
  •  ...CVS Health is seeking a qualified Registered Nurse for Utilization Management to ensure appropriate healthcare services and benefits for members. This role supports a 24/7 operation, including weekends and evenings, and requires strong clinical judgment and collaboration... 
    Remote work
    Afternoon shift

    Anacalifornia

    Sacramento, CA
    1 day ago
  •  ...CVS Health is seeking an experienced RN for Utilisation Management focusing on Medicare joint procedures. This remote, full-time role supports ensuring members receive the right care at the right time, collaborating with providers and care teams to coordinate effective... 
    Remote work
    Full time

    CVS Health

    Bastrop, LA
    4 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN Utilization Management Consultant. Be the first to apply!