- Legend Biotech USA, Inc. (Baton Rouge, LA)
- …Affairs team. Direct education for healthcare professionals treating oncology patients on clinical data, adverse event management , and mechanism of action for ... between investigators and members of the Legend Biotech Medical Affairs and Clinical Development teams; Addressing AE management and education as… more
- Kaiser Permanente (Baldwin Park, CA)
- …by: researching corrective action plan for areas of improvement identified through utilization review, clinical records audit, claim denials, member satisfaction ... Clinical Quality Expertise; Negotiation; Business Process Improvement; Risk Management ; Compliance Management ; Health Care Compliance; Applied Data Analysis;… more
- Ecumen (Sartell, MN)
- …bodies. Collaborates with the clinical team and Senior Living Consultant (s) to facilitate resident admissions. Promotes utilization of supportive services ... and assists with new hire onboarding, ongoing training, competency evaluations, performance management , and CEU verification for the clinical team. Delegates… more
- Duke University (Durham, NC)
- …stomas, draining wounds, or incontinence, throughout the organization. This includes utilization of clinical expertise to provide preoperative and postoperative ... within and across departments that promote patient safety, culturally competent care, and clinical excellence Serves as a resource and consultant to nursing… more
- Adventist Health (Los Angeles, CA)
- …in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, ... team and patient's healthcare benefactor to optimize outcomes. Serves as a consultant to the healthcare team on specific patient items. Coordinates a continuum… more
- Frederick Health (Frederick, MD)
- …are consistent with the PCMH model of care. Care is patient-centered by utilization care plans, self- management tools, and care coordination for high risk ... Advanced Practice Provider functions in the role of clinician, consultant , educator, researcher, and serves as a resource to...and serves as a resource to the physicians. Coordinates clinical services to provide consistent quality of care for… more
- University of Iowa Hospitals & Clinics (Iowa City, IA)
- …up visit appointment, provides medication, rehabilitation teaching, etc. Serve as a clinical resource or consultant for specific patient population. Participate ... is seeking a Nurse Clinician to function as a clinical nurse expert within the Emergency Department and care...on the plan of care recommendations and guiding the utilization of cost-effective resources. This position will manage a… more
- CVS Health (Frankfort, KY)
- …- SEE REQUIRED QUALIFICATIONS FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
- CVS Health (Charleston, WV)
- …and more compassionate. And we do it all with heart, each and every day. ** Utilization Management Clinical Consultant ** **Remote - West Virginia** ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
- CVS Health (Phoenix, AZ)
- …the lives of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven team that's ... Child Safety (DCS). + Knowledge of Behavioral Health Outpatient Services. + Utilization Management (UM) Experience. **Education** + Master's degree required for… more
- CVS Health (Baton Rouge, LA)
- …coverage required (as needed). As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Madison, WI)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- …care healthcare settings. Knowledge and ability to apply InterQual criteria, utilization management process, clinical documentation requirements, current ... Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental...criteria to perform basis review while developing technical and clinical competencies. The Nurse is a novice with limited… 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 (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management (UM) Nurse Consultant is a remote, full-time role ... external stakeholders. The position also involves coaching healthcare staff on utilization management principles and contributing to policy development.… more
- CVS Health (Jefferson City, MO)
- …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 Central Time zones… more
- CVS Health (Annapolis, MD)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function + Gathers clinical information and ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically… more
- CVS Health (Richmond, VA)
- …the VA licensure and compact licensure. Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize… more
- CVS Health (Annapolis, MD)
- …is Telework anywhere for prior authorization Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize… more
- Sanford Health (Bemidji, MN)
- …of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently holds ... or coordinates education to all internal customers related to compliance, coding, and clinical documentation issues and acts as a consultant to coders when… more
