- CVS Health (Columbus, OH)
- …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 ... options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- CVS Health (Raleigh, NC)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... There is no travel expected with this position. This UM Nurse Consultant position is...the membership of plan sponsor. As a Utilization Management Nurse Consultant , you will utilize clinical… more
- CVS Health (Olympia, WA)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is...work Pacific Time Zone hours. As a Utilization Management Nurse Consultant , you will utilize clinical… more
- CVS Health (Harrisburg, PA)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is...can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical… more
- CVS Health (Harrisburg, PA)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is...can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical… more
- CVS Health (Topeka, KS)
- …authorization experience + 5+ years of equipment experience including phone, computer, and clinical documentation systems + A Registered Nurse that must hold an ... health care more personal, convenient and affordable. Position Summary + Utilizes clinical skills to coordinate, document and communicate all aspects of the… more
- CVS Health (Albany, NY)
- …both verbal and written Required Qualifications + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... for this position are Monday-Friday 8a-5p EST. Position Summary + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Columbus, OH)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... schedule: Monday-Friday 8:00am-4:30pm EST. Position Summary As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate,… more
- CVS Health (Plantation, FL)
- …Monday-Friday; 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 ... Compact RN License or license in multiple states + UM Nurse Consultant experience +... clinical setting with diverse cultural dynamics of clinical staff and patients. Education Registered Nurse :… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan ... ISNP) Scheduled : Monday through Friday 9:30am to 6:00pm EST zone Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual contributor ... and escalate to senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against… more
- CVS Health (Phoenix, AZ)
- …coverage (URAC and Client Requirements). + Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for treatment and ... time is spent at a desk and on the telephone collecting & reviewing clinical information from providers. Required Qualifications + 1+ year: Oncology and Transplant … more
- US Tech Solutions (RI)
- **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from ... clinical records or systems to apply appropriate ...MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE… more
- CVS Health (Trenton, NJ)
- …Work from home anywhere in the USA. No travel is required. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, ... options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- CVS Health (Columbus, OH)
- …our Duals Program and is going to be auditing against the use of clinical criteria, policy procedures, and for compliance purposes. Schedule is Monday - Friday ... 8:00am - 5:00pm. Will have to maintain clinical review skills through he annual use of IRR....work with leadership for continual process improvement within Duals UM Program. Required Qualifications + RN with current unrestricted… more
- Bassett Healthcare (Cooperstown, NY)
- … as needed. Identifies need for patient to receive IM letter; collaborates with UM Nurse as needed. Assists Clinical Documentation Specialist in engaging ... skills necessary to provide care appropriate to each patient. Clinical and Technical Responsibilities: Provides case management services as...status and level of care matches order. Collaborates with UM Nurse to assure that all payor… more
- The Arora Group (Bethesda, MD)
- …Care Manager Certified (CMC) + Experience: + Referral Management/Utilization Management (RM/ UM ) experience. + Clinical subspecialty experience in Behavioral ... Registered Nurse Case Manager Nurse Currently recruiting...across the continuum of care. + Serves as a clinical case manager and patient advocate, providing advanced practice… more
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position at theCamp Pendleton **Branch Health Clinic** in ... such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, CM software, and databases for community resources.… more
- University of Miami (Miami, FL)
- …Accountabilities (For Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% 1. Works closely with the ... Cancer Center Sign-on Bonus: $25,000 T he Pediatric Chemotherapy Nurse will be a professional registered nurse ...health care, social services as needed. 15. Acts as consultant to clinical staff unfamiliar with pediatric… more
- University of Miami (Miami, FL)
- …Accountabilities (For Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% Works closely with the ... and clinical practice standards. Provides documentation to the Research Nurse / Nurse Coordinators, and/or Research Staff/Data Managers. Meets study timelines… more