New9h ago
- Specialty: Utilization Review
- Job type: Full-time
- Salary: $80,000 – $120,000
- License states: Maryland
RemoteBehavioral Health+2
Job details9h ago Curated
Utilization Management (UM) Nurse Consultant - Work at Home in EST or CST Zone
CVS Health- Utilization Review
- Full-time
- $70,000 – $90,000
- License: Compact
- 3+ years
Job description
The Utilization Management Nurse Consultant uses clinical judgment to review medical necessity for inpatient and outpatient services. This is a 100% remote role open to nurses with an active compact RN license. Requires 3+ years acute-care experience. BSN preferred. Salary range: $70,000–$90,000 plus benefits.
Key responsibilities
- Review medical necessity for inpatient and outpatient services
- Apply clinical criteria (InterQual/MCG) to determine appropriateness
- Document decisions and communicate with providers
What you bring
- Active compact RN license
- 3+ years acute-care experience
- Knowledge of InterQual or MCG criteria
Tags
100% RemoteCompact RNUtilization Management
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- New9h ago
- Specialty: Utilization Review
- Job type: Full-time
- Salary: $60,000 – $90,000
- License states: Maryland
RemoteBehavioral Health+2Job details - New9h ago
- Specialty: Utilization Review
- Job type: Full-time
- Salary: $70,000 – $90,000
- License states: Maryland
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