- CVS Health (Columbus, OH)
- …**Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out of the ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
- CVS Health (Carson City, NV)
- …reside in the PST zone** 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 (Austin, TX)
- …operation. Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant you will be responsible for ... the review and evaluation of clinical information and documentation related to outpatient therapy services....work Monday through Friday 8:00am to 5pm CST + Utilization management is a 24/7 operation. Work… more
- CVS Health (Oklahoma City, OK)
- …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 CST zones.… more
- Guardian Life (Bismarck, ND)
- **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
- Guidehouse (Chicago, IL)
- …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and operational improvement across business and purchased services, supply cost, and clinical supply utilization at client provider organizations. Our team of… more
- Houston Methodist (Houston, TX)
- …Center for Performing Arts Medicine. At Houston Methodist, the Speech Pathologist (SP) Clinical Consultant position is responsible for functioning as a licensed ... and acuities on an outpatient basis. As an experienced Therapist, the SP Clinical Consultant position provides education to patients, patient's family members… more
- Child Communication and Behavior Specialists (CA)
- …and culturally inclusive environment. The Position We are seeking a Remote BCBA Supervisor & Clinical Consultant to join our team. This role is 100% remote with ... individualized, high-quality ABA programs. Key Responsibilities + Provide hands-on clinical supervision using Behavioral Skills Training (BST). + Facilitate… more
- Highmark Health (Richmond, VA)
- …+ Deep Clincal Expertise -extensive knowledge of clinical , quality, care, utilization , high-cost claim, and population health management . Must be a ... Description :** **JOB SUMMARY** This job serves as the sales team's clinical expert, providing high-level support and insights for strategic clients, aligning… more
- Ochsner Health (New Orleans, LA)
- …at Ochsner Health and discover your future today!** The Physician Advisor (PA- Utilization Management ) serves as the physician leader in matters relating ... the Interdisciplinary and Post-Acute teams, Payors, Administration and Revenue Cycle) to improve utilization management , sustain quality goals, and act as a … more
- UPMC (Pittsburgh, PA)
- …with hospital administration and clinical teams. + Experience in utilization management and care coordination. + In-depth understanding of regulatory ... The Regional Medical Director, CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This… 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
- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... quality regulations. The PA will act as a liaison between the CDI ( Clinical Documentation Improvement) professional, HIM (Health Information Management ) ,and… more
- Tenet Healthcare (Detroit, MI)
- …Mgt. Leaders relating to Case Management scope of services, including utilization management , transition management promoting appropriate length of stay, ... and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention. … more
- Boehringer Ingelheim (Sacramento, CA)
- **Description** The Cardiovascular-Renal Sales Consultant is responsible for partnering in developing and implementing a plan for brand sales growth of BIPI and ... and with BIPI guidelines, policies, and directives. The Cardiovascular-Renal Sales Consultant will conduct their business with key targeted healthcare providers… more
- US Tech Solutions (RI)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
- Trinity Health (Pontiac, MI)
- …including senior management . + Proficiency with or ability to learn clinical information systems supporting PRM (Physician Relationship Management tools) + ... access, service and other operational issues identified by surgeons that inhibit utilization of and referrals to Trinity Health facilities, physicians, and services.… more
- Penn Medicine (Philadelphia, PA)
- …Research with a focus on supply chain, patient throughput, resource allocation and utilization , queuing theory and capacity management to help optimize business ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- PruittHealth (Columbia, SC)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... responsible for planning and directing clinical operations and quality improvement practices for designated centers. The senior nurse consultant provides… more
- J&J Family of Companies (Boston, MA)
- …more at https://www.jnj.com **Job Function:** MedTech Sales **Job Sub** **Function:** Clinical Sales - Surgeons (Commission) **Job Category:** Professional **All Job ... are searching for the best talent for a Sales Consultant Foot & Ankle to support clients in the...than 6 million people moving each year while delivering clinical and economic value to surgeons and healthcare systems.… more
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