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$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 workHourly payFull timeTemporary workWork at officeWork from homeShift workWeekend work$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 workHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift$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 workHourly payFull timeTemporary workWork at officeLocal areaWork from homeAfternoon shift$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 workHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayAfternoon shiftWeekday work- 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
- 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
- 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 jobWork at office
- 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 jobFull timeMonday to FridayWeekend work
- ...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 jobLive inHome officeWeekend workAfternoon shift
$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 workHourly payFull timeLocal area10 hours per weekFlexible hours$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 workHourly payFull timeTemporary workLocal areaWeekday work- 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 workFor contractorsWork at officeLocal areaWork from homeWork visa1 day per week
- ...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 workContract work
- ...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 officeWeekend work
$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 workHourly payFull timeTemporary workWork experience placementMonday to Friday$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 jobHourly payWeekly payContract workPart timeFor contractorsFlexible hoursNight shift$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 payFull timeTemporary workWork at officeLocal areaAfternoon shift- 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
- ...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
- ...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
- ...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 workFull time
- 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 workFull timeTemporary workWork from homeWork visaFlexible hours
- ...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
$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$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 workContract workImmediate startMonday to Friday- ...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 workFlexible hours
- ...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 workContract workWork at office
$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 workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeFlexible hoursWeekend workWeekday work- ...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 workWork at office
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