Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will ...
Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will ...
Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will ...
Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse's home. The Nurse will ...
Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone Preference: Pacific or Mountain Time Zone is preferred Work Schedule: Tuesday through Saturday, 8:00 AM - 5:00 PM PST ...
Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone Preference: Pacific or Mountain Time Zone is preferred Work Schedule: Tuesday through Saturday, 8:00 AM - 5:00 PM PST ...
Case Manager, Registered Nurse (Oncology experience required)
Phoenix, AZ · Remote
$54.10K - $155.54K/yr
... CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and ... Utilization Management. AHH delivers flexible medical management services that support cost ...
Case Manager, Registered Nurse (Oncology experience required)
Phoenix, AZ · Remote
$54.10K - $155.54K/yr
... CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and ... Utilization Management. AHH delivers flexible medical management services that support cost ...
Case Manager, Registered Nurse (Oncology experience required)
Phoenix, AZ · Remote
$54.10K - $155.54K/yr
... CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and ... Utilization Management. AHH delivers flexible medical management services that support cost ...
Case Manager, Registered Nurse (Oncology experience required)
Phoenix, AZ · Remote
$54.10K - $155.54K/yr
... CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and ... Utilization Management. AHH delivers flexible medical management services that support cost ...
Case Manager, Registered Nurse
Phoenix, AZ · Remote
$54.10K - $155.54K/yr
... CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and ... Utilization Management. AHH delivers flexible medical management services that support cost ...
Case Manager, Registered Nurse
Phoenix, AZ · Remote
$54.10K - $155.54K/yr
... CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and ... Utilization Management. AHH delivers flexible medical management services that support cost ...
Mental Health Therapist
Phoenix, AZ · Remote
$29.10 - $62.32/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... This is a 40 hour/week, fully remote position supporting clients ages 13+ in Arizona. Ideal ...
Mental Health Therapist
Phoenix, AZ · Remote
$29.10 - $62.32/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... This is a 40 hour/week, fully remote position supporting clients ages 13+ in Arizona. Ideal ...
tango is a leader in the home health management industry and is preparing for significant growth ... Remote Qualifications: * Working knowledge of home care and utilization management * Ability to ...
tango is a leader in the home health management industry and is preparing for significant growth ... Remote Qualifications: * Working knowledge of home care and utilization management * Ability to ...
... in this remote role. Preferred Qualifications: * X-Ray certification is highly preferred ... Excellent medical, dental, supplemental health, life and vision coverage for you and your ...
... in this remote role. Preferred Qualifications: * X-Ray certification is highly preferred ... Excellent medical, dental, supplemental health, life and vision coverage for you and your ...
Staff Software Development Engineer (Cloud & AI)
Scottsdale, AZ · Remote
$130.30K - $260.59K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... We will consider remote US for the right candidate Key Responsibilities * Shape and drive ...
Staff Software Development Engineer (Cloud & AI)
Scottsdale, AZ · Remote
$130.30K - $260.59K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... We will consider remote US for the right candidate Key Responsibilities * Shape and drive ...
Senior Software Development Engineer (DevOps)
Phoenix, AZ · Remote
$129.10K - $165.80K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... You will use your people management skills to support, manage and mentor other engineers with deep ...
Senior Software Development Engineer (DevOps)
Phoenix, AZ · Remote
$129.10K - $165.80K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... You will use your people management skills to support, manage and mentor other engineers with deep ...
Product Manager - Pharma
Scottsdale, AZ · On-site +1
$66.33K - $159.12K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Collaborate with Sales, Marketing, and Account Management teams to understand advertiser needs and ...
Product Manager - Pharma
Scottsdale, AZ · On-site +1
$66.33K - $159.12K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Collaborate with Sales, Marketing, and Account Management teams to understand advertiser needs and ...
Remote Prior Authorization Pharmacist
Yuma, AZ · Remote
$50 - $60.25/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital ... About Us We are a c onfidential healthcare partner working with health plans and PBMs across the U.
Remote Prior Authorization Pharmacist
Yuma, AZ · Remote
$50 - $60.25/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital ... About Us We are a c onfidential healthcare partner working with health plans and PBMs across the U.
Remote Prior Authorization Pharmacist
Phoenix, AZ · Remote
$58 - $69.75/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital ... About Us We are a c onfidential healthcare partner working with health plans and PBMs across the U.
Remote Prior Authorization Pharmacist
Phoenix, AZ · Remote
$58 - $69.75/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital ... About Us We are a c onfidential healthcare partner working with health plans and PBMs across the U.
... healthcare related field * 1 year' Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG ...
... healthcare related field * 1 year' Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG ...
Sr. Analyst-Internal Audit
Scottsdale, AZ · On-site +1
$46.99K - $112.20K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... line management. This role can be remote anywhere in the U.S. or hybrid based near one of our ...
Sr. Analyst-Internal Audit
Scottsdale, AZ · On-site +1
$46.99K - $112.20K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... line management. This role can be remote anywhere in the U.S. or hybrid based near one of our ...
Staff Software Engineer - Java Cloud (Health100 Platform)
Scottsdale, AZ · On-site +1
$118.45K - $284.28K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... This role can be based anywhere in the US; hybrid or remote with preference for candidates to work ...
Staff Software Engineer - Java Cloud (Health100 Platform)
Scottsdale, AZ · On-site +1
$118.45K - $284.28K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... This role can be based anywhere in the US; hybrid or remote with preference for candidates to work ...
Clinical Counselor - Employee Assistance Program
Phoenix, AZ · Remote
$59.10K - $77.90K/yr
Clinical Counselor - Employee Assistance Program At CVS Health, we're building a world of health ... Position Summary Fully remote in the USA. Shift: Sunday‐Thursday 2:00pm‐10:30pm EST.
Clinical Counselor - Employee Assistance Program
Phoenix, AZ · Remote
$59.10K - $77.90K/yr
Clinical Counselor - Employee Assistance Program At CVS Health, we're building a world of health ... Position Summary Fully remote in the USA. Shift: Sunday‐Thursday 2:00pm‐10:30pm EST.
Appeals Pharmacist (Remote)
Yuma, AZ · On-site +1
$49.25 - $60/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... About Us We are a confidential healthcare partner working with health plans and managed care ...
Appeals Pharmacist (Remote)
Yuma, AZ · On-site +1
$49.25 - $60/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... About Us We are a confidential healthcare partner working with health plans and managed care ...
Appeals Pharmacist (Remote)
Phoenix, AZ · On-site +1
$57 - $69.50/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... About Us We are a confidential healthcare partner working with health plans and managed care ...
Appeals Pharmacist (Remote)
Phoenix, AZ · On-site +1
$57 - $69.50/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... About Us We are a confidential healthcare partner working with health plans and managed care ...
Cvs Health Utilization Management Remote information
What is the difference between Cvs Health Utilization Management Remote vs Cvs Health Medical Reviewer?
| Aspect | Cvs Health Utilization Management Remote | Cvs Health Medical Reviewer |
|---|---|---|
| Credentials | RN, LPN, or other healthcare licenses | RN, MD, or DO licenses |
| Work Environment | Remote, home-based | Remote or onsite, depending on role |
| Employer & Industry Usage | Utilization management for insurance approvals | Medical review for claims and authorizations |
Both roles involve healthcare assessments, often requiring similar licenses. Utilization Management Remote focuses on reviewing medical necessity for insurance purposes, while Medical Reviewers may handle detailed case evaluations. Both are remote-friendly and integral to healthcare insurance processes, but differ slightly in scope and responsibilities.
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What are popular job titles related to Cvs Health Utilization Management Remote jobs in Arizona? For Cvs Health Utilization Management Remote jobs in Arizona, the most frequently searched job titles are:
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Full-time
Posted 12 days ago
Job description
Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM). These will be completely remote positions, working entirely from the Nurse’s home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of our Nation’s Active Duty and eligible retirees.
The Nurse will be working remotely Monday through Friday, 8 hours per day.
Requirements
- Bachelors Nursing Degree
- At least one active state nurse license, preferably compact state licensure
- At least 2 years’ experience working as an RNUM, preferably in a remote or hybrid environment.
- Possess current certification in either
- Completion of an accredited Certified Professional Utilization Review (CPUR) program
- Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.
--OR--
- Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.
- Highly organized, self-directed worker able to function in a high-volume environment without distractions.
- Strong verbal and written communication skills.
- Proficient level of experience with Microsoft Office applications and strong technical aptitude.
- Must have access to secure, high speed internet.
Company Overview:
Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans
US-AZ-Phoenix
Joseph Day
314-744-4138
joseph_day@spectrumhealth.com
About Spectrum Healthcare Resources
Sourced by ZipRecruiter
Spectrum is a leading organization that provides program management and physician and clinical staffing services to United States Military Treatment Facilities, VA Clinics and Federal Agencies. We are dedicated to the markets we serve, leading our organization’s experience for almost three decades.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Saint Louis, MO, US
Year founded
1988