- Veterans Affairs, Veterans Health Administration (Colorado Springs, CO)
- Summary The Quality Management (QM) Consultant -Regulatory Compliance Registered Nurse (RN) demonstrates leadership, experience, and creative approaches ... to improvement in quality of-care outcomes. The QM Consultant -Regulatory Compliance...organizational level within a facility. Responsible for their assigned quality management program area activities for the… more
- CVS Health (Raleigh, NC)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health ... ensuring compliance with regulatory and accreditation standards while driving healthcare quality initiatives. This role combines clinical expertise with quality … more
- US Tech Solutions (RI)
- …support as required. **Responsibilities:** + Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit ... Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION... review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
- Veterans Affairs, Veterans Health Administration (Fort Harrison, MT)
- Summary The Registered Nurse (RN) Quality Management (QM) Performance Measures Consultant will function as an advanced clinician and execute position ... for accreditation/external review functions, performance measures, patient safety, and quality management functions. Function as a facilitator, educator,… more
- CVS Health (Austin, TX)
- …is 100% remote and the candidate can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... and more compassionate. And we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role… more
- CVS Health (Columbus, OH)
- …do it all with heart, each and every day. **Position Summary** 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
- CVS Health (Columbus, OH)
- …difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll ... organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high- quality healthcare for members. **Position… more
- CVS Health (Raleigh, NC)
- …and evening hours._ **Must reside in CST or EST zone.** As a Utilization Management Nurse Consultant you will utilizes clinical experience and skills ... And we do it all with heart, each and every day. **Position Summary** _Utilization Management is a 24/7 operation and work schedule will include weekends, holidays… more
- CVS Health (Lansing, MI)
- …that promote high- quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant , where you'll apply ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- CVS Health (Raleigh, NC)
- …with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization Management ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 3, Consultant Mental Health; Central Office Occupational Category Health Care, Human/Social ... of Mental Health is recruiting to fill a Registered Nurse 3 Consultant Mental Health, G-22, position...at State Operated Facilities and Programs to improve the quality of patient care. Serve as the OCNS lead… more
- PruittHealth (Columbia, SC)
- **Description - External** **JOB PURPOSE:** Senior Nurse Consultant assumes responsibility for conducting quality assurance reviews in the assigned ... facilities. Senior Nurse Consultant recommends resources in an efficient and economical manner...* Desired Software: Matrix Care, Point Right, AHT, Abaqis ( Quality Management System), COMS * Expert level… more
- Polaris Pharmacy Services, LLC (Livermore, CA)
- Nurse Consultant Job Details Job Location Polaris Pharmacy Services of Northern CA - Livermore, CA Position Type Full Time Salary Range $40.00 - $42.00 Hourly ... services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring...invite you to grow with us. Job Summary: The Nurse Consultant position is an external position… more
- NHS Management, LLC (Fayetteville, AR)
- …the successes they experience along the way. We are in search of a qualified Regional Nurse Consultant : The Regional Nurse Consultant will be responsible ... the dissemination of expert advice and oversight to facility management personnel and line staff to ensure that systems...care facilities to ensure that the highest degree of quality care can be provided to the residents at… more
- HCA Healthcare (Fort Walton Beach, FL)
- …you passionate about delivering patient-centered care?** Submit your application for Registered Nurse Lactation Consultant position and spend more time at the ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at HCA...your career! We are interviewing candidates for our Registered Nurse Lactation Consultant opening. **Apply today and… more
- CVS Health (Atlanta, GA)
- …we do it all with heart, each and every day. **Position Summary** _Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more
- CVS Health (Carson City, NV)
- …and every day. **Must Reside in PST Time Zone** **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, ... other products, services and/or programs. + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. + Consults and… more
- CVS Health (Harrisburg, PA)
- …compassionate. And we do it all with heart, each and every day. Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and ... to coordinate, document and communicate all aspects of the utilization/benefit management program. + Applies critical thinking and knowledge in clinically… more
- CVS Health (Phoenix, AZ)
- … organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high- quality healthcare for members. **Position ... Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the forefront of clinical… more
- CVS Health (Richmond, VA)
- …auditing of approval, extensions, and denial letters. Promotes and supports quality effectiveness of the healthcare services. Maintains accurate and complete ... documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally and externally to enhance effectiveness of… more