Remote Utilization Management Nurse Consultant

4004 Aetna Medicaid Administrators

Remote job

CVS Health is seeking a remote Precertification Nurse to review clinical information and authorize procedures from providers. The role is telework everywhere with a preference for Virginia residents or those with Virginia licensure. You will collect data by phone, apply evidence-based criteria, and initiate Medical Director referrals as needed. Candidates must hold an active RN license with at least an Associate’s degree and 3+ years of nursing experience. #J-18808-Ljbffr 4004 Aetna Medicaid Administrators

Apply

Vacancy posted 3 days ago

Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse Consultant in Virginia, MN vacancy

Remote Utilization Management Nurse Consultant
...CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant to join our remote team. This 100% work-from-home role serves members across the CST zone, ensuring safe, appropriate care and timely approvals. You will review clinical documents, collaborate...
Remote work
Work from home
Santa Barbara Cottage Hospital
United States
11 hours ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking a Utilization Management Nurse Consultant to assess, plan, and coordinate healthcare services for members. This role involves 24/7 coverage with weekend/evening hours and requires strong clinical judgment and cross-functional collaboration. Critical...
Remote work
Work from home
Weekend work
Afternoon shift
4062 Aetna Resources, LLC
United States
23 hours ago
Remote Utilization Management Nurse Consultant
...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
IntelliResume
United States
4 days ago
Remote Utilization Management Nurse Consultant
...CVS Health is seeking a remote Utilization Management Nurse Consultant (RN) to review authorization requests across medical specialties and determine medical necessity using evidence-based guidelines. The role emphasizes collaboration with providers and care teams to...
Remote work
NurseRemotely
United States
2 days ago
Remote Utilization Management Nurse Consultant (RN)
...CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% remote role available to CST Zone residents in the United States. You will review medical necessity, coordinate care, and ensure timely, appropriate services while meeting state and...
Remote work
Full time
NurseRemotely
United States
2 days ago
Utilization Management Nurse Consultant
$26.01 - $56.14 per hour
...something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | 24/7 Operations Are you an experienced Registered Nurse looking to apply your clinical...
Remote work
Hourly pay
Full time
Temporary work
Work at office
Local area
Work from home
Afternoon shift
CVS Health
United States
2 days ago
Utilization Management Nurse Consultant
$29.1 - $62.32 per hour
...Registered Nurse (RN) – Utilization Management Remote | Work from Home | Eastern Time Zone Preferred Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive...
Remote work
Hourly pay
Full time
Temporary work
Work from home
Afternoon shift
Oak St. Health
United States
3 days ago
Utilization Management Nurse Consultant
$32.01 - $68.55 per hour
...care one person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Perm Schedule- Monday-Friday 8a-5p EST Position...
Remote work
Hourly pay
Permanent employment
Full time
Temporary work
Work at office
Local area
Work from home
Monday to Friday
Afternoon shift
CVS Health
New York, NY
3 days ago
Utilization Management Nurse Consultant
$29.1 - $62.32 per hour
...Position Summary Utilizes clinical skills to coordinate... ...utilization/benefit management program. Requires an... ...resource optimization. Consults with and provides... ...coaching and guidance to nursing staff and other... ...Consultant role is 100% remote and the candidate can...
Remote work
Hourly pay
Full time
Temporary work
Work experience placement
Live in
Work at office
Local area
Monday to Friday
Shift work
Afternoon shift
CVS Health
Mountain Home, TX
2 days ago
Utilization Management Nurse Consultant
$32.01 - $68.55 per hour
...with heart, each and every day. Position Summary This Utilization Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and is a fully remote role. Candidates must hold a New York Registered Nurse license. The employee will work four 10-hour days...
Remote work
Hourly pay
Full time
Local area
10 hours per week
Flexible hours
The Muse
Albany, NY
4 days ago
Utilization Management Nurse Consultant
$26.01 - $56.14 per hour
...something bigger - helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Remote | Work from Home | Central Time Zone Preferred Are you an experienced Registered Nurse looking to expand your...
Remote work
Hourly pay
Full time
Temporary work
Work at office
Local area
Work from home
Afternoon shift
CVS Health
Topeka, KS
2 days ago
Epic Tapestry Utilization Management (UM) Workflow Configuration Consultants
...forward. As a healthcare IT consulting and staffing firm, we help health... ...26 - 12/31/2026 Location: Remote We are seeking experienced Epic Tapestry Utilization Management (UM) Workflow Configuration... ...of Prior Authorization nurses, reviewers, and care management...
Remote work
Health Data Movers
United States
11 hours ago
Senior Utility Management Consultant
...Blue Cypress Consulting is building its Pacific Northwest (PNW) practice, and we are looking for a Senior Utility Management Services (UMS) Consultant to help lead that growth from the... ...This is a hybrid position (in office/remote). We offer a telecommute option to work...
Remote work
Full time
For contractors
Work at office
Local area
Work from home
Work visa
1 day per week
Blue Cypress Consulting, LLC
Seattle, WA
2 days ago
Utilization Management Nurse Consultant
...Utilization Management Nurse Consultant Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in...
Work at office
Weekend work
Integrated Resources
Downers Grove, IL
2 days ago
Utilization Management Nurse Consultant
$26.01 - $68.55 per hour
...reviewing clinical information from providers. Precertification nurses use specific criteria to authorize procedures/services or initiate... ...e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links....
Remote work
Hourly pay
Full time
Temporary work
Work experience placement
Work at office
Local area
Work from home
Monday to Friday
Rotating shift
4004 Aetna Medicaid Administrators
Virginia, MN
3 days ago
RN Care Management(Remote)
...Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization Management and collaborate with...
Remote work
Humana
United States
3 days ago
RN Care Management(Remote)
$60.15 - $85.81 per hour
...Job Summary: The Utilization Management Nurse supports the case management department by providing a variety of utilization management functions... ...weekend coverage ~ Hybrid Position - Primarily remote/work-from-home, with an expectation to be on-site at least...
Remote work
Full time
Work experience placement
Work from home
Shift work
Valley Children's Healthcare
Madera, CA
4 days ago
RN Care Management(Remote)
...Collaborating with the Medical Director, the full-time Registered Nurse Utilization Review will manage care variance reduction, ensure timely discharges, and refer members to appropriate resources while working remotely. Key responsibilities Assist in building and implementing...
Remote work
Full time
Virtual Vocations Inc
United States
1 day ago
RN Care Management(Remote)
...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
Appworks
United States
11 hours ago
Registered Nurse - Utilization Review
...Registered Nurse - Utilization Review About Company Bestica: We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation...
Remote work
Bestica Healthcare
United States
2 days ago
RN Virtual Health Services I
...Registered Nurse – Utilization Review (Remote) Position Overview: This is a fully remote Utilization Review RN role supporting multiple service... ...Qualifications: Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (...
Remote work
3B Healthcare, Inc.
Torrance, CA
2 days ago
RN Care Management(Remote)
$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 work
Bi-weekly pay
Full time
Temporary work
For contractors
Local area
Work from home
Guidehealth
United States
11 hours ago
Registered Nurse-RN - Virtual Hospital
...Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective... ...Commission/ Core Measure/National Safety Goals Additional Skills remote UR work CA and Medi-Cal experience/knowledge*
Remote work
B2B Staffing Services
Torrance, CA
2 days ago
Healthcare Nurse - Remote
...Registered Nurse - Utilization Review The right role can make all the difference in your career... ...computer literate; experience working remote; degree accreditation verification or five... ...of experience. Responsibilities: Manage utilization review processes, ensuring...
Remote work
Contract work
Rotating shift
VyTalent Solutions
Fort Myers, FL
3 days ago
Registered Nurse Utilization Review
...skilled and experienced Registered Nurse with specialties in Medical/... ...skilled nursing care, case management, and hospice care to... ...Certifications: Experience in Utilization Review or case management... ...to work independently in remote settings. Must be able to...
Remote work
Flexible hours
vTech Solution
Santa Rosa, CA
3 days ago
Registered Nurse - Utilization Review (Nursing)
$1,600 - $1,800 per week
...Now Hiring: Registered Nurse – Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,60... ...Friday, 0730–1630 No weekends, no holidays, no telehealth/remote work Minimum Qualifications U.S. Citizenship (required...
Remote work
Contract work
Immediate start
Monday to Friday
J Edward Staffing LLC
Aurora, CO
2 days ago
RN Care Management(Remote)
...The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and discharge planning activities. The... ...organizations, or patient's home which may be in understaffed/remote areas, in the presence of pets or family members that are...
Remote work
Full time
Work at office
North East Medical Services
Burlingame, CA
4 days ago
Travel RN - Virtual Care
$2,220 per week
...Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers... ...~ Employment Type: Travel REMOTE POSITION Facility: Lee Health... ...RN – Utilization Review / Utilization Management Contract: 13 weeks Guaranteed:...
Remote work
Weekly pay
Contract work
Work experience placement
Monday to Friday
Shift work
Weekend work
Care Career
Fort Myers, FL
3 days ago
Nurse Care Management LPN (Virtual)
$60k
...LVN experienced in the managed care payor environment... ...and post-service utilization reviews and appeals for... ...SKILLS/ABILITIES The UM Nurse’s responsibilities include... ...cases to independent consultants or IROs, when... ...development opportunities Remote Opportunities We are actively...
Remote work
Temporary work
Local area
Integra Partners
New York, NY
1 day ago
Travel RN - Virtual Care
$2,065 per week
...Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job... ...Review Extension (UR EXT) specialist for a remote position. This role involves conducting utilization management activities, requiring collaboration...
Remote work
Temporary work
Zero hours contract
Monday to Friday
Shift work
Weekend work
Cross Country Nurses
Fort Myers, FL
13 days ago

Do you want to receive more vacancies?

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