- Adecco US, Inc. (Woonsocket, RI)
- Adecco is currently assisting a local client, recruiting for Quality Management Registered Nurse Consultant working from home. For instant consideration, ... Apply Now! Requires an RN with unrestricted active license 3 years of clinical experience required- Managed Care/Medicare experience required.( This experience is not negotiable ) Schedule: M-F 8-5 Responsible for the review and evaluation of clinical… more
- US Tech Solutions (May, OK)
- …regulatory and accreditation requirements for member and/or provider issues. Works Potential Quality of Care cases across all lines of business (Commercial and ... support as required. **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit… more
- CVS Health (Springfield, IL)
- …years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in state of residence ... - 5:00pm in time zone of residence Preferred Qualifications - Utilization Management review - Managed Care experience - Client processing experience Education… more
- CVS Health (Scottsdale, AZ)
- …Components/Expectations* Serve as an incident reporting expert for Aetna Care Management .* Lead and demonstrate the How We Work Behaviors (specifically ... incident reporting* Mentor the care team regarding best practice standards, quality of interventions, problem resolution and critical thinking and standard operating… more
- CVS Health (Richmond, VA)
- …Qualifications - 3+ years of clinical experience required - 3+ years of Quality experience required - Virginia resident required - Licensed RN with current ... unrestricted state of Virginia licensure required - Must possess reliable transportation and be willing and able to travel approximately 10% of the time. Mileage is reimbursed per our company expense reimbursement policy - 1+ year of experience using Microsoft… more
- CVS Health (Raleigh, NC)
- …of the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- CVS Health (Columbus, OH)
- …role is fully remote and employee can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... document and communicate all aspects of the utilization/benefit management program. You would be responsible for ensuring the...times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all… more
- Indian Health Service (Phoenix, AZ)
- Summary This position serves as the Risk Management Consultant at the Phoenix Service Unit covering inpatient, ambulatory care, and emergency areas. Incumbent ... the Director of Regulatory Compliance and Accreditation Department, Chief, Quality Management Officer, the Service Unit ...the risk of adverse patient events. Serves as a consultant providing clinical advisory tasks related to such functions… more
- CVS Health (Columbus, OH)
- …deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and ... pm EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Plantation, FL)
- …10:00 AM- 6:30 PM EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties include (not all encompassing): -Reviews services to assure ... Spanish highly preferred + Compact RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas access to care + Working… more
- CVS Health (Lansing, MI)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and ... employee can live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and ... Eastern Standard Time Holiday rotation 1-2 per year. CCR - Duals UM Nurse ConsultantUtilizes clinical experience and skills in a collaborative process to assess,… more
- CVS Health (Austin, TX)
- …care more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more
- CVS Health (Columbus, OH)
- …make health care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA ISNP) ... with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and… more
- Trinity Health (Mishawaka, IN)
- …in technology, people and capabilities that allow us to set the standard for quality care. **JOB SUMMARY** The inpatient CWOCN Consultant will provide clinical ... and their family members to assist them in the management of their individual wound care needs. Ultimate responsibility...for the patient, unit based resource nurses and the Nurse Manager of each unit. The CWOCN Consultant… more
- Truman Medical Centers (Kansas City, MO)
- …(http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Corporate Clinical Nurse Consultant RN-Behavioral Health (8:00am - 4:30pm) ... and Pharmacy. A 547-bed, not-for-profit health system, UH delivers the highest- quality medical care for our patients, with compassion, empathy, and unparalleled… more
- ERP International (Anchorage, AK)
- **Overview** ERP International is seeking a **Registered Nurse Lacation Consultant ** for a full-time position supporting the673d Medical Group, Joint Base ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- CVS Health (Phoenix, AZ)
- …on Arizona time zone. No weekends, holidays are required. The UM Clinical Consultant utilizes clinical skills to coordinate, document and communicate all aspects of ... the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and medical necessity… more
- Brockton Hospital (Brockton, MA)
- …with the appropriate management of their lactation needs. + Acts as consultant , educator, and participative role model to medical and nursing staff involved in ... and augment teaching provided by nursing staff. + Evaluates the lactation management program/services through quality improvement studies. + Orients new… more
- CVS Health (Columbus, OH)
- …the US Work hours: 8:30am-5:00pm EST, Monday-Friday. This position is for a UM nurse consultant who will be joining our reconsideration team. A reconsideration ... nurse will review any additional information submitted within the...coordinate, document and communicate all aspects of the utilization/benefit management program. Utilizes clinical experience and skills in a… more
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