- Battelle Memorial Institute (Oceanside, CA)
- …with the referring provider, behavioral health consultant and/or psychiatry consultant + Perform case management functions **Key Qualifications** + Master ... and Analytics (HRA) business line is seeking a highly motivated, full-time **Licensed Clinical Social Worker (LCSW)** to join our team in support of our government… more
- Moses/Weitzman Health System (Meriden, CT)
- …component meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and ... licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or… more
- CVS Health (Raleigh, NC)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Oklahoma City, OK)
- …a psychiatric or behavioral health setting required. + Strong knowledge of clinical practice guidelines and utilization management . **Required** ... clinical skills to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply critical thinking and… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide ... clinical insight into product development and testing as well...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Austin, TX)
- …can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all aspects ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant ...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical… more
- CVS Health (Columbus, OH)
- …Mon-Fri 10:30AM-7PM with alternate weekends and holidays **Position Summary:** UM Nurse Consultant Utilizes clinical experience and skills in a collaborative ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** - 2+ years of… more
- CVS Health (Harrisburg, PA)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- CVS Health (Lansing, MI)
- …Summary** Join our Utilization Management team as a Nurse Consultant , where you'll apply clinical judgment and evidence-based criteria to review ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function + Gathers clinical information and ... do it all with heart, each and every day. Utilization Management is a 24/7 operation and...may include weekends, holidays and evening hours. + Utilizes clinical skills to coordinate, document and communicate all aspects… more
- CVS Health (Springfield, IL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** ** Utilization Management is a 24/7 operation and work schedules will include weekends, ... holidays, and evening hours.** Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence** **- Utilization Management is a 24/7 operation and… more
- 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 ... hours. This is a full-time, remote role. + Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and… more
- CVS Health (Phoenix, AZ)
- …promote high-quality healthcare 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 forefront of clinical decision-making, applying your expertise in Behavioral Health to...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- CVS Health (Trenton, NJ)
- …and unrestricted RN licensure in New Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work ... Nurse, any compact licensure must cover New Jersey** + Utilization Management is a 24/7 operation and...and evening hours. + Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for… more
- CVS Health (Albany, NY)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management opportunity for RNs with a **New York** state licensure. ... with active and unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience **Preferred Qualifications**… more
- CVS Health (Richmond, VA)
- …with an unrestricted license in state of residence. 1+ years of clinical experience **Preferred Qualifications** Utilization Management experience Managed ... services. Maintains accurate and complete documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally… more
- Vitalief (New Brunswick, NJ)
- …and achieve sustainable growth. The Role We are seeking a highly experienced Clinical Research Operational Management Consultant to lead a short-term ... and accelerate breakthroughs that improve patient care. We bring deep clinical research expertise together with practical, results-driven consulting to help… more
- CareFirst (Baltimore, MD)
- …**Experience:** 5 years experience in business development, operational technology support, Utilization Management (UM) operations, Clinical Product ... role will focus specifically on optimizing end-to-end business processes within Utilization Management . **ESSENTIAL FUNCTIONS:** + Provide deep subject matter… more
- BD (Becton, Dickinson and Company) (San Jose, CA)
- …This position reports to the Regional Business Manager and supports the Specimen Management business unit. This role observes current clinical practice and ... responsibilities will include:** + Fosters a continually evolving partnership between Specimen Management and our valued customers in a Clinical Process advisory… more
