Utilization Management Nurse Consultant - Remote

Remote Full-time
About the position Responsibilities • Utilizes clinical experience to assess and facilitate appropriate healthcare services for members. • Gathers clinical information to render precertification coverage determinations. • Communicates with providers and other parties to facilitate care and treatment. • Identifies members for referral opportunities to integrate with other products and services. • Promotes benefit utilization opportunities. Requirements • 3+ years of acute experience as a Registered Nurse. • Active current and unrestricted RN licensure in state of residence. • 1+ year(s) of experience with MS Office suites. Nice-to-haves • Managed Care experience • Medicare experience Benefits • Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays. Apply tot his job
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Account Management Specialist - Northwell

Remote

Executive Assistant and Office Administrator job at Milliken in Westlake, OH

Remote

Experienced Remote Customer Service Representative – Delivering Exceptional Support and Benefits Guidance to Union Members and Veterans at blithequark

Remote

Software Developer - Early Career

Remote

Senior Pay Per Click Strategist

Remote

[Remote] Engineering Intern - Spring 2026

Remote

**Experienced Home-Based Customer Service Representative – Deliver Exceptional Support Experience to Clients Across the Nation**

Remote

`100% Remote | Weekly Pay | Urgently Hiring - Start This week!

Remote

[Remote] Administrative Assistant to the CEO (Unpaid Volunteer Position)

Remote

Experienced Customer Support Specialist for blithequark - Delivering Exceptional Technical Support to Global Clients

Remote
← Back