• Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    …members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the ... times may vary based on business needs) Location: 100% Remote (US only) **About Us** American Health Holding, Inc....a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
    CVS Health (10/31/25)
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  • Clinical Registered Nurse

    Cognizant (Annapolis, MD)
    …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (11/15/25)
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  • Utilization Review Nurse

    Martin's Point Health Care (Portland, ME)
    …of clinical nursing experience as an RN, preferably in a hospital setting + Utilization management experience in a health plan UM department Required License(s) ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible...to lower/higher levels of care, makes referrals for care management programs, and performs medical necessity reviews for retrospective… more
    Martin's Point Health Care (11/15/25)
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  • Utilization Management Nurse

    Humana (Little Rock, AR)
    …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...PHI / HIPAA information ​Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    Humana (Springfield, IL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...to help support business needs + This is a remote / work at home position and candidates can… more
    Humana (11/13/25)
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  • Utilization Management Nurse

    Access Dubuque (Dubuque, IA)
    Utilization Management Nurse **Cottingham &...** **Location** : Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse ... Utilization Management Nurse...also work closely with participants for referrals to case management and condition management services according to… more
    Access Dubuque (10/24/25)
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  • Utilization Management Nurse

    Humana (St. Paul, MN)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (11/16/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …and evening hours._ _This positions hours will be M-F with Weekend/Holiday Rotation._ **UM Nurse Consultant** Fully Remote - WFH **Position Summary** UM Nurse ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 3+ years of… more
    CVS Health (11/15/25)
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  • Utilization Management Nurse

    CVS Health (Lansing, MI)
    … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...some weekends and holidays, per URAC and client requirements. ** Remote Work Expectations** + This is a 100% … more
    CVS Health (11/13/25)
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  • Utilization Management Nurse

    CVS Health (Carson City, NV)
    …heart, each and every day. **Must Reside in PST Time Zone** **Position Summary** Utilization Management is a 24/7 operation and work schedules will include ... weekends, holidays, and evening hours. This is a full-time, remote role. + Utilizes clinical experience and skills in...and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and… more
    CVS Health (11/11/25)
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