- Kaiser (Wailuku, HI)
- …Participates in clinical team meetings, departmental planning, and quality management activities.Complies with organizational, departmental, state/federal ... process facilitation, influence, interpersonal relations, oral communication, problem solving, quality management , teamwork and written communication.Experience in… more
- CVS Health (IL)
- …members according to HFS quality strategy and ABHIL population health model. The Quality Management , Nurse Consultant directs analysis and reporting ... the development of HEDIS interventions and initiatives within the Quality Management Team. - Reviews documentation and...health care related field. - 1 year of project management experience. - Registered Nurse (RN) license… more
- CVS Health (IL)
- …Contracting and Performance Management - 3 years Managed Care and/or Healthcare Quality Experience - 2 years Project Management - 1year experience Member ... Summary** This role is responsible for managing partnerships with Aetna-Illinois quality vendors and community-based organizations, with the primary focus to improve… 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
- CVS Health (OH)
- …3+ years of clinical experience required. + 2+ years of Utilization Management experience required + 2+ years' experience using personal computer, keyboard ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- CVS Health (MI)
- …promote high- quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant - Oncology and Transplant to join ... 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
- HCA Healthcare (Houston, TX)
- …we support our colleagues in their positions. Join our Team as a Registered Nurse RN Lactation Consultant and access programs to assist with every stage ... more affordable to gain certifications and job skills. Apply today for our Registered Nurse RN Lactation Consultant opening and continue to learn! **Job Summary… more
- CVS Health (FL)
- …in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and… more
- CVS Health (AZ)
- …in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and Transplant, ... organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high- quality healthcare for members. **Position… more
- MyFlorida (Quincy, FL)
- LICENSED PRACTICAL NURSE (Pending reclassification to a Health Educator Consultant )- 64051236 Date: Sep 30, 2025 The State Personnel System is an E-Verify ... Requisition No: 862103 Agency: Department of Health Working Title: LICENSED PRACTICAL NURSE (Pending reclassification to a Health Educator Consultant )- 64051236… 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
- Polaris Pharmacy Services, LLC (Livermore, CA)
- Nurse Consultant Job Details Job Location Polaris Pharmacy Services of Northern CA - Livermore, CA Salary Range $40.00 - $45.00 Hourly Job Category ... advancement to all our team members. Job Summary: The Nurse Consultant position is an external position...in drug availability, drug storage, and distribution + Conduct quality assurance audits prior to survey window to ensure… more
- Humana (Oviedo, FL)
- …health first** The Nurse Senior Stars Improvement, Clinical Professional/ Consultant contributes to the development, implementation, and management of the ... Data and Information Set (HEDIS), Patient Safety, and Patient Experience. The Nurse Senior Stars Improvement, Clinical Professional / Consultant focuses on… more
- PruittHealth (Fayetteville, NC)
- **JOB PURPOSE:** The Nurse Consultant collaborates with the Senior Vice President Clinical Services and the hospice regional team to provide compliance support ... services to hospice agencies. The consultant is responsible for providing program evaluation, education and...operations and federal and state regulations. 2. Knowledge of Nurse Practice Act and acceptable standards of Nursing Practice… 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
- HCA Healthcare (Denver, CO)
- …of the range. **Introduction** Do you have the career opportunities as a Registered Nurse Lactation Consultant you want in your current role? We invest in ... Development Educator enhances professional practice and the provision of quality patient care by providing evidence-based quality ...path, we encourage you to apply for our Registered Nurse Lactation Consultant opening. We review all… more
- CVS Health (Columbus, OH)
- …utilization/benefit management function. + UMNC meets set productivity and quality expectations. + Effective communication skills, both verbal and written + ... products, services and/or benefit programs. + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. + Consults… more
- CVS Health (OH)
- …management organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high- quality healthcare for members. We ... are seeking a dedicated Utilization Management (UM) Nurse to join our remote...Lead is instrumental in onboarding new team members, monitoring quality , triaging assignments, and leading designated projects. Acting as… more
- PruittHealth (Norcross, GA)
- **HomeHealth Consultant position - Hybrid and Travel opportunity!** **JOB PURPOSE:** The Home Health Consultant collaborates with the Home Health Agencies by ... projects as assigned. 8. Supports Home Health agencies in achieving high quality outcomes and patient satisfaction scores. 9. Demonstrates honesty and integrity at… more
- CVS Health (OH)
- …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
