- 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
- Cardinal Health (Atlanta, GA)
- **Ideal candidate will live near a major/regional airport.** **_What Clinical Operations contributes to Cardinal Health_** Clinical Operations is responsible for ... and service education to facilitate technology adoption and workflow change management . + Demonstrates extensive knowledge and understanding of relevant clinical… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for...external committees as delegated or assigned. Serves as a consultant to other departments or organizations as needed. Responsible… more