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

Remote Utilization Management Nurse Consultant

Santa Barbara Cottage Hospital

CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full‑time role serving candidates in the EST or CST zones. You will coordinate, document, and communicate utilization and benefit management activities to ensure appropriate care while complying with state and federal requirements.

The role involves reviewing clinical documentation, collaborating with providers, and supporting cost‑effective, high‑quality care.

#J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Utilization Management Nurse Consultant in United States vacancy
  • $29.1 - $62.32 per hour

     ...determined in collaboration with management to ensure adequate weekend...  .... Position Summary Utilize your clinical experience and...  ...and benefit utilization. Consult and lend expertise to other internal...  ...Registered Nurse Education: Diploma RN acceptable... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work at office
    Work from home
    Shift work
    Weekend work

    Oak St. Health

    United States
    3 days ago
  • $26.01 - $68.55 per hour

     ...UM Nurse Consultant Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. Fully Remote- WFH M-F 8a-5p EST/9a-6p CST With 1 hour lunch Position Summary Utilizes clinical experience and skills in a... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work at office
    Work from home
    Afternoon shift

    Minnesota Jobs

    United States
    4 days ago
  • $26.01 - $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 M-F 8a-5p EST/9a-6p CST With 1 hour lunch... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area
    Work from home
    Afternoon shift

    CVS Health

    Home, PA
    4 days ago
  • $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...  ...one person, one family and one community at a time. Remote | Full-Time | Weekday Schedule Are you a Registered... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area
    Monday to Friday
    Afternoon shift
    Weekday work

    Avery Healthcare Group Ltd.

    United States
    2 days ago
  • 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 job
    Work from home

    CVS Health

    New York, NY
    3 days ago
  • 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 job
    Work from home

    CVS Health

    New York, NY
    14 hours ago
  • 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 job
    Full time
    Work from home

    CVS Health

    Phoenix, AZ
    5 days ago
  • CVS Health is seeking a Nurse Consultant to assess and coordinate healthcare services for members in a fully remote role. You will apply clinical criteria, gather information...  ...Office/IT systems. Outpatient or utilization management experience is a plus; BSN preferred.... 
    Remote job
    Work at office

    University of Minnesota School of Nursing

    Brooklyn, NY
    1 day ago
  • CVS Health is seeking an experienced Utilization Management (UM) Nurse Consultant for a 100% remote, full-time role open to EST residents across the U.S. You will apply clinical expertise to ensure members receive safe, appropriate and cost-effective care. Schedule: Monday... 
    Remote job
    Full time
    Monday to Friday
    Weekend work

    CVS Health

    Raleigh, NC
    3 days ago
  •  ...Health Corporation is seeking an experienced Registered Nurse for Utilization Management. The role examines and coordinates care options, applying...  ...a 24/7 environment with weekends, holidays and evenings. Remote work is supported for colleagues who live in-state, with... 
    Remote job
    Live in
    Home office
    Weekend work
    Afternoon shift

    CVS Health Corporation

    Brooklyn, NY
    5 days ago
  • $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
    3 days ago
  • $26.01 - $68.55 per hour

    Utilization Management Nurse - Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization Management team and play a key role in ensuring members... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Local area
    Weekday work

    CVS Health

    Denver, CO
    1 day ago
  • Blue Cypress Consulting is seeking a Senior Utility Management Services (UMS) Consultant to support current projects and facilitate the expansion of our utility...  ...of this job. This is a hybrid position (in office/remote). We offer a telecommute option to work once a week... 
    Remote work
    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
  •  ...Remote, RI Contract Job Description: Responsible for the review and evaluation of clinical information and documentation...  ...with Medcompass ~ Must have prior authorization utilization experience. ~ Managed Care/Medicare experience preferred. Skills: MUST... 
    Remote work
    Contract work

    US Tech Solutions

    United States
    10 hours ago
  •  ...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
    1 day ago
  • $60.52k - $129.62k

     ...alignment with relevant project plans. Manages and coordinates specific workplans for...  ...publications, and/or facilitating research utilization to improve clinical care and outcomes....  ...technical writing skills ~ Registered Nurse (RN) required. Adept at problem solving... 
    Remote work
    Hourly pay
    Full time
    Temporary work
    Work experience placement
    Monday to Friday

    Oak St. Health

    United States
    3 days ago
  • $80 - $120 per hour

     ...Remote | Utilization Management & Case Management Clinical Review Consultant We are sharing a specialised part-time consulting opportunity for United States-based healthcare...  ...Active clinical licensure, with a Registered Nurse license required for nursing leadership... 
    Remote job
    Hourly pay
    Weekly pay
    Contract work
    Part time
    For contractors
    Flexible hours
    Night shift

    24-MAG LLC

    New York, NY
    3 days ago
  • $32.01 - $68.55 per hour

    Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends...  ...Services and benefit utilization. Consults and lends expertise to other internal...  ...+ years of experience as a Registered Nurse in adult acute care/critical care setting... 
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area
    Afternoon shift

    CVS Health

    Springfield, IL
    4 days ago
  • 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 job
    Work from home

    CVS Health

    Louisiana, MO
    2 days ago
  •  ...Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of...  ...Observation (OBS). Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (... 
    Remote work

    3B Healthcare, Inc.

    United States
    4 days ago
  •  ...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
    1 day ago
  •  ...To support effective patient management, the full-time Registered Nurse Utilization Review will conduct initial and concurrent reviews of medical records to...  ...reimbursement, and prevent payment denials while working remotely. Key responsibilities Reviews and evaluates... 
    Remote work
    Full time

    Virtual Vocations Inc

    United States
    5 days ago
  • Senior Utility Process Consultant – Electric Distribution Patrol & Inspection Location: Remote (Work from home eligible) Position Overview Celerity is seeking a Senior Business...  ..., engineering, vegetation, asset management, and compliance Document current-state... 
    Remote work
    Full time
    Temporary work
    Work from home
    Work visa
    Flexible hours

    Celerity Consulting Group, LLC

    Walnut Creek, CA
    2 days ago
  •  ...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
    4 days ago
  • $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
    4 days ago
  • $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
    1 day ago
  •  ...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
    2 days ago
  •  ...About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in...  ...and a member’s benefit coverage while working remotely. Primary Responsibilities •    Performs... 
    Remote work
    Contract work
    Work at office

    Brighton Health Plan Solutions

    United States
    2 days ago
  • $71.1k - $97.8k

     ...caring community The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical nursing skills to support the coordination...  ...role includes a required holiday rotation. This is a remote position. This role is responsible for overseeing... 
    Remote work
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Work from home
    Home office
    Flexible hours
    Weekend work
    Weekday work

    Humana

    Columbus, OH
    5 days ago
  •  ...Forest City NC locations; Remote Option Projected Hiring...  ...proactive intervention and care management consultation and support to promote high...  ...The Care Management Nurse Consultant is responsible for...  ...and inappropriate service utilization Assists in quality of care... 
    Remote work
    Work at office

    Partners Health Management

    Forest City, NC
    1 day ago

Do you want to receive more vacancies?

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