- CVS Health (Columbus, OH)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area- + Managed Care experience preferred, especially Utilization Management + Preference for those residing in EST zones **Education** +… more
- CVS Health (Tallahassee, FL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days...their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3+ years of… more
- CVS Health (Frankfort, KY)
- …and every day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a work from home anywhere in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate,… more
- CVS Health (Baton Rouge, LA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** - Licensed… 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 ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… 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 ... + Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. **Skills:** + MUST HAVE… more
- Lincoln Financial (Columbus, OH)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- CVS Health (Richmond, VA)
- …improvement. **Required Qualifications** + RN licensure required. + 3-5 years of Utilization Management (UM) clinical experience required. **Required Skills:** + ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- CVS Health (Raleigh, NC)
- …9:00 PM EST approximately quarterly **Job Descriptions** The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and ... Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits… more
- CVS Health (Harrisburg, PA)
- …Skilled Nursing (SNF) and Assisted Living (ALF) facilities. The Clinical Nurse Specialist/Infusion Educator for LTC (Long Term Care) will work collaboratively ... facilities in the surrounding area and other states as needed. The Clinical Nurse Specialist/Infusion Educator LTC is responsible for the below, most of which must… more
- Truman Medical Centers (Kansas City, MO)
- …time **Work Schedule** 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** ** Utilization Management Nurse (UM RN)** _Optimize Care. Improve Outcomes. ... log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care Continuity -… 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: Full ... 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
- 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
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical information ... * Remote in Hampton Roads* Summary The Utilization Review Nurse combines clinical expertise...Experience: Greater than 3 years clinical nursing experience required. Utilization management experience preferred. Must be self-directed… more
- Access Dubuque (Dubuque, IA)
- …degree nursing program.** **Active and current license for Registered Nurse ** **Active and current International Board-Certified Lactation Consultant ... Lactation Consultant - Birth Center **MercyOne** 1 Positions ID:...health and wellness, particularly as it relates to breastfeeding management and early parenting issues.** **Helps breastfeeding women and… more
- McLaren Health Care (Lansing, MI)
- …the Patient Care Coordinator or Patient Care Manager, the Certified Lactation Consultant independently provides consultations to management for routine and ... or Practical Nurse by State of Michigan. * Certified Lactation Consultant (IBCLC) by the International Board of Lactation Consultant Examiners. * American… more
- MyFlorida (Orlando, FL)
- …Bachelor's Degree in any other discipline with at least 6 months of direct case management experience or a Florida Licensed Registered Nurse (RN) with 1-year of ... HUMAN SERVICES PROGRAM CONSULTANT II - 64006362 Date: Apr 7, 2025...(CBO's). Incumbent reports directly to the Supervisor of Case Management . Staff will establish and maintain a caseload of… more
- MyFlorida (Tallahassee, FL)
- REGISTERED NURSING CONSULTANT - 64064600 Date: Apr 26, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... 847535 Agency: Department of Health Working Title: REGISTERED NURSING CONSULTANT - 64064600 Pay Plan: Career Service Position Number:...This position will join a group of other Registered Nurse Consultants with the NBS Nursing Unit. The ability… more
- Lincoln Financial (Columbus, OH)
- …in a behavioral health setting including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health ... We are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization. As a Behavioral Health Consultant , you… more
- Defense Health Agency (Honolulu, HI)
- …the military and civilian facilities is informed of these guidelines. l. Acts as Nurse Consultant through holistic approach to address health care needs in ... **Overview** ** Nurse (Case Management ) Tripler Army Medical...to identify potential barriers to optimal health and resource utilization . Identifies methods for minimizing such barriers and assists… more
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