- Segal (Chicago, IL)
- …assure and measure the effectiveness of PBM and Healthcare company cost and utilization management programs and clinical services.Qualifications:| Minimum of ... pharmacy benefits data? This opportunity may be for you!Our Senior Consultant , Pharmacy Benefits Financial Analysis creates and analyzes pharmacy benefits financial… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of improving the health of our communities. About the Role:Job SummaryThe clinical informatics specialist (CIS) functions as a consultant , educator, and ... solutions to improve patient care.Knowledge and expertise in patient care management , clinical quality analytics, and value-based reimbursement/accountable care… more
- EY (Dallas, TX)
- …Value Analysis / Clinical Supply Chain Clinical Utilization /Consumption Procurement Logistics / Distribution Inventory management Operations Strategy ... 7 years of progressive experience as a clinician and consultant A bachelor's degree and approximately 10 years of...Physician Alignment (preferably an MSN, JD or MD) including clinical variation, resource utilization and physician engagement… more
- Inova Health System (Fairfax, VA)
- …system. Assesses patient needs and coordination of multidisciplinary care. Serves as a clinical consultant to the health care team.- Coordinates a patient's plan ... resources. Acts as advisor/educator by providing emotional support, counseling, clinical education, resources and expert guidance to patients and families… more
- Saint Francis Health System (Tulsa, OK)
- …error, and support decision-making. Working knowledge of general disease state management processes, bio-psychosocial model, and clinical pathways. Ability to ... manner. Ability to be detail oriented as required in the examination of clinical and numerical data. Ability to demonstrate comfort and ease of familiarity with… more
- Adventist Health (Glendale, CA)
- …assisting in 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. Job Requirements: Education… more
- CVS Health (Baton Rouge, LA)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : + Licensed independent… more
- CVS Health (Richmond, VA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : - Must have ... solutions to make health care more personal, convenient and affordable. Utilizes clinical experience and skills in a collaborative process to plan, implement,… more
- CVS Health (Phoenix, AZ)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Gathers clinical information and ... time zone. No weekends, holidays are required. The UM Clinical Consultant utilizes clinical skills...of Arizona or Compact RN licensure Preferred Qualifications: + Utilization management experience preferred. + Acute care… more
- CVS Health (Austin, TX)
- …more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience and ... EST zone (twice per month) Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience + MedCompass Education… more
- CVS Health (Raleigh, NC)
- …membership of plan sponsor. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... make health care more personal, convenient and affordable. 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)
- …can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all aspects ... to make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Plantation, FL)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical experience and skills ... (not all encompassing): -Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization , facilitates safe… more
- Immigration and Customs Enforcement (IN)
- … Review Consultant will report directly to the IHSC Regional Utilization Manager with the Utilization Management Program Administrator. This ... DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert...cases for high level of review and participates in Utilization Management Review Committee activities as needed.… more
- CVS Health (Columbus, OH)
- …and deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote ... 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 (Lansing, MI)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote ... live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in...external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+… 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 external constituents in the coordination and administration of the utilization /benefit management function.Required Qualifications* 3+ years of experience… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+ years of ... care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA ISNP) Scheduled :… more
- CVS Health (Baton Rouge, LA)
- …Qualifications + 5+ years of clinical experience + 1+ year(s) of utilization management , concurrent review and/or prior authorization experience + 5+ years ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in a… more
- CVS Health (Trenton, NJ)
- …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
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