Remote Utilization Management Nurse - Spine Specialist
CVS Health Corporation
- Remote job
CVS Health Corporation is seeking an experienced Utilization Management Nurse Consultant for the Spine Team, working remotely. You will review spine-related prior authorizations, apply MCG guidelines, assess records, and collaborate with providers and Medical Directors to support appropriate coverage decisions. The role requires an active RN license, 3–5+ years of clinical nursing, and strong analytical and communication skills, with a remote-friendly setup and strict HIPAA compliance. #J-18808-Ljbffr CVS Health Corporation
- ...expertise as well as knowledge of utilization and discharge planning... ...the department Vice President/Manager of Regulatory Audits and ensures... ...Required -Registered Nurse Diploma Preferred - Associate... ...position you are interested in is remote or on-site. Individuals who reside...Remote jobFull timeWork experience placementLocal areaImmediate startFlexible hoursWeekend work
- ...Health Corporation is seeking an experienced Oncology Nurse Consultant to lead clinical care management and utilization coordination across a patient’s cancer journey.... ...optimize outcomes while controlling costs. Fully remote nationwide role with ongoing professional...Remote job
- CVS Health is seeking a Utilization Management Nurse Consultant for the Specialty Spine Team to work remotely. You will review spine-related authorization requests, apply medical necessity guidelines, and collaborate with providers and Medical Directors to ensure timely...Remote job
- CVS Health Corporation invites an experienced Utilization Management Nurse Consultant to join the Spine Team in a remote, full-time capacity. You will review spine-related prior authorizations, apply evidence-based criteria, and collaborate with providers and Medical Directors...Remote jobFull time
- ...Strategy Business Process Blueprints Enterprise Architecture and EnterpriseTransformation. Role : Utilization Management Nurse Specialist Location: 100% Remote Duration: 3-Month Contract (Potential for Extension) Job Description: We are seeking an...Remote workContract workWork at office
- ...Job Description Job Description We are seeking a Field Manager for utility access road construction and data mapping to become an integral part of our team! Days consisting of exploring remote access roads, managing field operations, using GIS technology, and supporting...Remote workFull timeWork at officeWork from homeFlexible hours
- ...Medix is seeking a highly skilled Utilization Review Nurse Specialist for a fully remote role in the United States. The RN will assess medical necessity and level-of-care decisions, collaborating with physicians and payers to ensure appropriate care and revenue integrity...Remote work
- Elevance Health is seeking a Wound Care Utilization Management RN to work primarily virtually with periodic in-person training sessions. The role requires an active RN license, WOCN or CWS certification, and at least 3 years in diverse health care settings. The RN will...Remote jobWork from home
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workFull timeWork from home
- Integra Partners seeks an experienced Utilization Management Nurse Supervisor to lead the UM nursing team, ensuring performance, accountability,... ...staff and overseeing case assignments and authorizations in a remote, nationwide work environment. #J-18808-Ljbffr...Remote job
- CVS Health is seeking an Utilization Management Clinical Consultant to apply clinical expertise in coordinating care and ensuring appropriate benefits across care levels. This role leverages evidence-based guidelines, triage, crisis support, and collaboration with providers...Remote jobFull timeWork from home
- Centene seeks a licensed nurse to perform concurrent reviews of inpatient admissions for pediatric and adult members within the... ...acute care experience. Knowledge of Medicare/Medicaid regulations and utilization management is preferred. #J-18808-Ljbffr Centene CorporationRemote jobWeekend work
- A leading payment management solutions provider seeks an Offsite Invoice Payment Specialist to manage utility invoice entries in a work-from-home setup. The role requires high... ...operational efficiency and accuracy in a supportive environment. J-18808-Ljbffr Remote Jobs SolutionsRemote jobWork from home
- Integrated Management Strategies, LLC is seeking an experienced Sr Review Coordinator for our healthcare consulting practice. This fully remote role within the United States focuses on utilization review of plans of service for home and community-based programs, supporting...Remote jobWork from home
- ...Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations... ...make critical patient-care decisions. This full-time, remote position offers a competitive salary and comprehensive...Remote workFull time
- ...CVS Health is seeking a Utilization Management Nurse Consultant for a fully remote position. You will review medical necessity, facilitate discharge planning, and collaborate with providers to support members with complex needs. Qualifications include ADN required,...Remote work
$34 - $35 per hour
Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from... ...Global Talent Attraction and Branding Specialist Lead @ BroadPath | Employee... ...Review Nurse- Prior Authorization Remote Registered Nurse (Remote Patient Monitoring...Remote workFull timeWork at officeWork from homeNight shift- ...Humana is seeking a Utilization Management Nurse to leverage clinical nursing skills in coordinating, documenting, and communicating medical service determinations. The role requires independent interpretation and decision making within established guidelines, with collaboration...Remote work
- ...Job Description: Ascension Texas Utilization Management Department (Fully Remote)Job Summary:• Provides health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:• Reviews admissions and service requests within...Remote work
$219k - $286.9k
Oscar Health is hiring a Physician Reviewer to join our Utilization Management team. You will determine the medical appropriateness of inpatient... ...information and applying evidence-based guidelines. This remote role in the United States offers work from home with occasional...Remote jobWork from home- The Utilization Management Nurse supports the Case Management Department by performing a variety of utilization management functions to promote appropriate... ...rotating weekend coverage Hybrid Position - Primarily remote/work-from-home, with an expectation to be on-site at least...Remote workFull timeWork from homeShift work
$45.31 - $67.01 per hour
...Job Description: The Nurse Clinical Leader provides leadership... ...within their department. They manage unit resources and supervise personnel... ...the care of patients. The RN utilizes the nursing process with... ...expectations. If applying for a remote or hybrid role, this includes...Remote workHourly payShift work$32.01 - $68.55 per hour
...CVS Health Utilization Management Position We're building a world of health around every individual — shaping a more connected, convenient... ...Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have...Remote workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state regulations, URAC standards, and Guidehealth policies. This role applies...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...in the United States is seeking an Inpatient Utilization Management Clinician to evaluate inpatient medical necessity... ...planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience with InterQual guidelines...Remote workFull time
- ...Utilization Management Nurse BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical... ...requirements, and a member's benefit coverage while working remotely. Primary Responsibilities: Performs clinical utilization...Remote workContract workWork at office
$29.1 - $62.32 per hour
...Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your clinical expertise to ensure members receive the...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to FridayAfternoon shiftWeekday work- ...Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join... ...regulations (LCD/NCD policies). This is a fully remote opportunity requiring discipline, accuracy, and effective...Remote work
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation... ..., 0730-1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications ~ U.S. Citizenship...Remote workContract workImmediate startMonday to Friday$32.01 - $68.55 per hour
## Utilization Management Nurse ConsultantApply: Remote: IL - Work from home: Work At Home-Ohio: Work At Home-Texas: Work At Home-Georgia: Work At Home-West Virginia: Full time: Posted Today: End Date: October 11, 2026 (4 days left to apply): R1047682We’re building a world...Remote workHourly payFull timeTemporary workWork at officeWork from homeMonday to FridayAfternoon shift
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