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Remote Cvs Utilization Management Nurse Jobs in Minnesota

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... Risk Management/Insurance, Math, Statistics, Business Analytics, Economics (and related majors)

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... Risk Management/Insurance, Math, Statistics, Business Analytics, Economics (and related majors)

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... Risk Management/Insurance, Math, Statistics, Business Analytics, Economics (and related majors)

CVS Health

Remote/Virtual (Using your own personal laptop/computer) Program Overview: * Unpaid Educational ... Risk Management/Insurance, Math, Statistics, Business Analytics, Economics (and related majors)

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Remote Cvs Utilization Management Nurse information

What is the difference between Remote Cvs Utilization Management Nurse vs Remote Cvs Case Manager?

AspectRemote Cvs Utilization Management NurseRemote Cvs Case Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification
Work EnvironmentUtilization review teams, insurance companiesPatient advocacy, care coordination teams
Employer & IndustryHealth insurance, managed care organizationsHealth insurance, healthcare providers

Both roles require RN licensure and related certifications, but the Utilization Management Nurse focuses on reviewing medical necessity and approving services, while the Case Manager emphasizes coordinating patient care and discharge planning. Understanding these differences helps job seekers find the right fit within the healthcare and insurance industries.

What are the most commonly searched types of Cvs Utilization Management Nurse jobs in Minnesota?

The most popular types of Cvs Utilization Management Nurse jobs in Minnesota are:

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For Remote Cvs Utilization Management Nurse jobs in Minnesota, the most frequently searched job titles are:

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Cities in Minnesota with the most Remote Cvs Utilization Management Nurse job openings:

Remote Cvs Utilization Management Nurse jobs near you
Infographic showing various Remote Cvs Utilization Management Nurse job openings in Minnesota as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution.

Behavioral Health Utilization Management Clinician

Adecco

Minneapolis, MN • Remote

$39 - $41.40/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago

Job description

Adecco Healthcare & Life Sciences is currently hiring a Behavioral Health Utilization Management Clinician for a remote telecommute opportunity in Nevada.

This is a remote opportunity with a Monday–Friday schedule.

Please review the details below and apply with an updated resume for consideration.

Position Details:

·       Pay: $39 to $41.40/hour

·       Contract: Four to Six-Contract, possibility of extension or becoming permanent

·       Location: Remote / Telecommute

·       Schedule: Monday–Friday, 8:00 AM–5:00 PM PST

Primary Responsibilities:

·       Review outpatient ABA requests for medical necessity using established clinical criteria, including MCG, InterQual, ASAM, and plan-specific guidelines.

·       Evaluate treatment plans, progress reports, assessments, and supporting documentation submitted by providers.

·       Collaborate with providers to clarify documentation and ensure the appropriate level of care.

·       Make determinations or recommendations for approval, modification, or denial of services.

·       Document clinical decisions and rationale accurately in the utilization management system.

·       Review clinical information and apply established guidelines to support appropriate behavioral health services.

·       Manage multiple cases in a high-volume, deadline-driven environment.

·       Collaborate with internal clinical and administrative teams to support quality patient care.

Qualifications:

·       BCBA, LBA, RN, Master's degree in Social Work, or related behavioral health field.

·       LCSW, LPC, LMFT, or equivalent behavioral health credentials accepted.

·       Active, unrestricted behavioral health license in the State of Nevada preferred.

·       Minimum of 2 years of behavioral health clinical experience, including ABA experience.

·       Familiarity with Medicaid and commercial benefit structures and utilization management protocols.

·       Experience reviewing clinical documentation and determining medical necessity.

·       Ability to work independently and effectively within a remote team environment.

·       Proficiency with clinical systems, Microsoft Office applications, and electronic documentation platforms.

·       Strong ability to multitask and meet deadlines in a high-volume environment.

·       Experience in behavioral health utilization management or prior authorization.

Why Work for Adecco?

·       Excellent Weekly Pay

·       401(k) Plan

·       Skills Training

·       Medical, Dental, and Vision Benefits


Pay Details: $39.00 to $41.40 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.