• Utilization Review Nurse

    Martin's Point Health Care (Portland, ME)
    …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
    Martin's Point Health Care (12/23/25)
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  • Utilization Review Nurse

    Actalent (Houston, TX)
    "Urgent Hiring for " Utilization Review RN" Job Description: + Perform concurrent reviews to assess member's overall health. + Review the type of care being ... setting of care. Qualifications: + 4+ years experience in utilization management and utilization review /managed...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
    Actalent (01/02/26)
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  • Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    …for 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....intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
    CVS Health (12/13/25)
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  • Clinical Registered Nurse

    Cognizant (Salem, OR)
    …Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,...Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan +… more
    Cognizant (12/23/25)
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  • Utilization Review Nurse

    Actalent (Rancho Cordova, CA)
    Utilization Review Nurse About the Role We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, ... cost‑effective patient care from a fully remote environment. This role is ideal for nurses who...ensure appropriate levels of care. Key Responsibilities + Conduct utilization reviews for inpatient, outpatient, and ancillary services using… more
    Actalent (12/24/25)
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  • RN Utilization Review - Full-time…

    Providence (Irvine, CA)
    **Description** **RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, ... retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical...for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers,… more
    Providence (01/01/26)
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  • Utilization Management Nurse

    CVS Health (Austin, TX)
    …+ Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live ... care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care +… more
    CVS Health (01/01/26)
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  • RN Utilization Review Full- time…

    Providence (Mission Hills, CA)
    …time **Job Shift:** Multiple shifts available **Career Track:** Nursing **Department:** 7000 UTILIZATION MGMT REMOTE **Address:** CA Mission Hills 15031 Rinaldi ... **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical reviews and review medical records… more
    Providence (12/16/25)
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  • Utilization Management Nurse

    CVS Health (Austin, TX)
    …with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any ... care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care +… more
    CVS Health (01/01/26)
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  • Utilization Management Nurse

    CVS Health (Carson City, NV)
    …with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in PST zone.** ... cardiology **Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care -Strong… more
    CVS Health (12/21/25)
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