Remote Medicare Utilization Nurse Consultant
CVS Health
- Remote job
CVS Health is seeking a Utilization Management Nurse Consultant (Clinical Precertification RN, Medicare) to review clinical cases and determine coverage using evidence-based guidelines in a remote, full-time weekday schedule. You will collaborate with providers and care teams, applying clinical judgment to support utilization and benefit management decisions while identifying opportunities to improve care quality and member outcomes. #J-18808-Ljbffr CVS Health
- CVS Health seeks a NICU Utilization Management Nurse Consultant to support high-risk neonatal populations through clinical review, care coordination, and evidence-based decision-making. This remote role requires an active RN license, NICU nursing experience, and familiarity...Remote jobWork from home
- MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare services, communicating...Remote jobFull timeFreelanceWork at officeMonday to FridayWeekend work
- ...holidays and generous paid time off Location: Remote-USA The Role: Denial Prevention Nurse Consultant Primarily responsible for thorough review of... ...years of related experience and/or training in utilization review or patient accounting Are highly...Remote workWork at officeWork from home
$71.1k - $97.8k
...The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical nursing... ...prior to review by the Humana G&A Medicare Medical Directors. You will review the... ...required holiday rotation. This is a remote position. This role is responsible for...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend workWeekday work$66.58k - $142.58k
...Position Summary CVS Aetna is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you will play a critical role in... ...Preferred Qualifications Appeals, Managed Care, or Utilization Review experience. Proficiency with computer skills...Remote workHourly payFull timeTemporary workLocal areaMonday to FridayShift work- CVS Health is recruiting an Appeals Nurse Consultant to process medical necessity for Medicare Part C appeals. The role combines independent and team work in a remote setting, with a 40-hour weekly schedule and occasional weekend/holiday rotations. Required RN licensure...Remote job
- CVS Health in the United States is seeking an Appeals Nurse Consultant to evaluate Medicare Part C medical necessity for members and providers. This role... ...blends independent action with team collaboration in a remote setting. The position features a 40-hour work week,...Remote jobWeekend work
- CVS Health is seeking an Appeals Nurse Consultant to review and determine medical necessity for Medicare Part C appeals from members and providers. This production role... ..., and the ability to work independently in a remote, fast-paced environment. Typical schedule includes...Remote jobWeekend work
- CVS Health in Idaho is seeking an Appeals Nurse Consultant to process the medical necessity of Medicare Part C appeals. This full-time role requires an active RN... ...focused on safe, quality care. The role supports remote work within the U.S. time zones. #J-18808-Ljbffr...Remote jobFull timeWeekend work
$71.1k - $97.8k
...Join Our Caring Community The Utilization Management Registered Nurse uses clinical nursing skills to interpret... .... Experience working in a fully remote, metrics-focused role Experience... ...Experience as an RN for a Medicare Certified Home Health agency Health...Remote workBi-weekly payTemporary workWork at officeHome office- ...Remote, RI Contract Job Description: Responsible for the review and evaluation of clinical information... ...experience with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills: MUST HAVE...Remote workContract work
$71.1k - $97.8k
...and Help Us Put Health First The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...Health Plan experience Previous Medicare/Geriatric Experience a plus Bilingual... ...Monday-Friday Travel: While this is a remote position, occasional travel to...Remote workBi-weekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$26.01 - $56.14 per hour
...person, one family and one community at a time. Utilization Management Nurse Consultant (RN) - Concurrent Review Remote | Acute Inpatient Utilization Management | RN... ...Qualifications BSN preferred Experience in Medicaid, Medicare, or Commercial Health Plan Utilization...Remote workHourly payFull timeTemporary workWork experience placementWork at officeLocal areaWork from home$26.01 - $56.14 per hour
...responsible for performing utilization management (UM)... ...services, including Skilled Nursing Facilities (SNF),... ...of care. The UM Nurse Consultant evaluates medical necessity... ...in Medicaid, Medicare, or Commercial Health... ...Experience working in a remote environment. Education...Remote workHourly payFull timeTemporary workLocal area$66.58k - $142.58k
...contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. Provides training and... .../presentation and technical writing skills ~ Registered Nurse (RN) required. Adept at problem solving and decision-making...Remote workHourly payFull timeTemporary workWork experience placementWork from homeMonday to Friday- Concentric Energy Advisors, Inc. seeks a Principal Consultant - Utility Revenue Requirements Specialist to prepare and defend revenue requirements... ...filings for utility clients across North America, with remote work options. You will handle regulatory filings, testify as...Remote job
$26.35 - $39.53 per hour
...Utilization Management Nurse, LVN/LPN Remote NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled... ...to all populations across the ACA Marketplace, Medicare, and Medicaid. NeueHealth delivers clinical care to...Remote workHourly payWork at office- An established industry player seeks a Principal Consultant to lead utilities civil litigation efforts. This role involves providing expert guidance, managing client relationships, and overseeing complex legal cases. The ideal candidate will have extensive experience in...Remote job
- ...SUMMARY As an International Consultant, you will provide onsite consulting... ...individual’s health status. Nurse: Graduate of an approved... ...biomedical equipment, and/or utility systems as well as experience... ...procedures (e.g., emergency exits, remote storage areas, infection...Remote workContract workCurrently hiringLong distanceFlexible hours
$26.01 - $62.32 per hour
...Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) We're building a world of health around every individual — shaping a more connected, convenient... ..., one family and one community at a time. Remote | Full-Time | Weekday Schedule Are you a...Remote workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work$200k
Principal Consultant - Utilities Civil Litigation Job Title: Principal Consultant - Utilities Civil Litigation Location: Washington, DC, Marlborough, MA, or remote Company Description: Concentric Energy Advisors, Inc. ( ) (“Concentric”) is an employee-owned leading management...Remote workWork at officeFlexible hours$21.68 - $31.08 per hour
...Participation in a holiday and weekend coverage rotation is required. Work Location: This is a fully remote, permanent work-from-home position. What will YOU be doing for us? Utilize internal practices and policies to perform regular audits of authorization case work...Remote workHourly payPermanent employmentSecond jobWork at officeWork from homeWeekend work$114k - $161k
Job Title: Principal Consultant - Utility Return on Equity & Cost of Capital Specialist Job Location: Marlborough, MA headquarters Position Type: Hybrid - 3 days in office, 2 remote days per week 2025 Salary Range: $114,000 - $161,000 plus annual incentive compensation...Remote workWork at officeWork from homeFlexible hours2 days per week$128k - $191k
Job Title Principal Consultant - Utility Revenue Requirements Specialist Location Marlborough, MA or Washington, DC; open to remote employees Company Description Concentric Energy Advisors, Inc. ( (“Concentric”) is an employee‑owned management consulting and financial...Remote workWork at officeFlexible hours- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home role in the EST time zone. The position supports utilization management and benefit coordination, requiring an active RN license and hospital experience. Responsibilities...Remote jobWork from home
- CVS Health is seeking a Registered Nurse for Utilization Management on a work-from-home schedule with weekend coverage. You will assess, plan, implement, coordinate, monitor, and evaluate options to facilitate healthcare services and member benefits. Responsibilities include...Remote jobWork from home
$58.24k - $72.8k
ERM is seeking a Remote Utility Project Support Specialist to assist with customer inquiries regarding utility line projects. This part-time role involves managing a high volume of calls and ensuring customer satisfaction. The ideal candidate will possess strong communication...Remote jobPart time- ...solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-... ...requests, ensuring compliance with Medicare guidelines, and collaborating with... ...utilization review. Competitive pay and remote flexibility offered. #J-18808-LjbffrRemote work
- ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of... ...similar managed care organizations. Strong knowledge of Medicare regulations and associated utilization management...Remote work
- CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely, safe, and appropriate care...Remote jobFull timeWork from home
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicare Utilization Nurse Consultant. Be the first to apply!
- database consultant Austin, TX
- work from home nurse consultant Austin, TX
- fitness consultant Austin, TX
- global consultant Austin, TX
- temporary consultant Austin, TX
- workplace consultant Austin, TX
- program consultant Austin, TX
- itsm consultant Austin, TX
- home consultant Austin, TX
- banking consultant Austin, TX

