• Utilization Management

    CVS Health (OH)
    …**Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out of the ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
    CVS Health (10/02/25)
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  • Behavioral Health Utilization

    CVS Health (Frankfort, KY)
    …all with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant . **Must reside in the state of ... other internal and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to… more
    CVS Health (09/13/25)
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  • Utilization Management Nurse…

    CVS Health (FL)
    …must reside in Florida** . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... internal and external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information and… more
    CVS Health (09/30/25)
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  • Utilization Management Nurse…

    CVS Health (VA)
    …And we do it all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a ... Utilization Nurse Consultant , you will utilize clinical skills to...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
    CVS Health (09/26/25)
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  • Utilization Management Nurse…

    CVS Health (MI)
    …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant - Oncology and Transplant ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
    CVS Health (09/25/25)
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  • Utilization Management Nurse…

    CVS Health (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 ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET zones **Education**… more
    CVS Health (10/03/25)
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  • Utilization Management Nurse…

    CVS Health (AZ)
    …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... 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 (10/01/25)
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  • Utilization Management Nurse…

    CVS Health (MI)
    …able to work Sunday through Thursday, 9:30am to 6:00pm CST/EST with holiday rotation; Utilization Management is a 24/7 operation and work schedule will include ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… more
    CVS Health (09/26/25)
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  • Utilization Management Nurse…

    CVS Health (Workman, MN)
    …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 decision-making, applying your expertise in Behavioral Health to...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
    CVS Health (10/04/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... each and every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including every Weekend**… more
    CVS Health (09/20/25)
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  • Utilization Management Nurse…

    CVS Health (OH)
    …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... projects. Acting as the first point of contact for clinical issues, the Team Lead provides guidance and support...in medical healthcare. + 3+ years Medical Review or Utilization Management experience. + 2+ years of… more
    CVS Health (09/24/25)
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  • Clinical Research Operational…

    Vitalief (New Brunswick, NJ)
    …and achieve sustainable growth. The Role We are seeking a highly experienced Clinical Research Operational Management Consultant to lead a short-term ... and accelerate breakthroughs that improve patient care. We bring deep clinical research expertise together with practical, results-driven consulting to help… more
    Vitalief (08/17/25)
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  • Principal Provider Performance Clinical

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Cross and Blue Shield of Minnesota Position Title: Principal Provider Performance Clinical Consultant Location: Hybrid | Eagan, Minnesota Career Area: Strategic ... and leading consultative conversations with provider groups about opportunities to improve clinical and cost/ utilization trend. * Responsible for developing and… more
    Blue Cross and Blue Shield of Minnesota (09/06/25)
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  • Specimen Management Clinical

    BD (Becton, Dickinson and Company) (San Jose, CA)
    …This position reports to the Regional Business Manager and supports the Specimen Management business unit. This role observes current clinical practice and ... responsibilities will include:** + Fosters a continually evolving partnership between Specimen Management and our valued customers in a Clinical Process advisory… more
    BD (Becton, Dickinson and Company) (09/25/25)
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  • UM Clinical Consultant

    CVS Health (OK)
    … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** : + Unrestricted… more
    CVS Health (09/10/25)
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  • Medical Economics Consultant (Pop Health/…

    Molina Healthcare (San Antonio, TX)
    …the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position ... analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for… more
    Molina Healthcare (09/05/25)
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  • Senior Provider Performance Clinical

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …and leading consultative conversations with provider groups about opportunities to improve clinical and cost/ utilization trend. * Responsible for developing and ... all lines of business. The role works in tandem with the Manager of Clinical Consultation, Pr Provider Performance Clinical Consultants, and the Medical Director… more
    Blue Cross and Blue Shield of Minnesota (09/06/25)
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  • Utilization Management RN Hourly…

    Truman Medical Centers (Kansas City, MO)
    …standards, and financial goals. + Serve as an internal consultant to clinical staff, providing guidance on utilization practices, clinical documentation, ... 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
    Truman Medical Centers (10/02/25)
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  • Remote BCBA Supervisor & Clinical

    Child Communication and Behavior Specialists (CA)
    …and culturally inclusive environment. The Position We are seeking a Remote BCBA Supervisor & Clinical Consultant to join our team. This role is 100% remote with ... individualized, high-quality ABA programs. Key Responsibilities + Provide hands-on clinical supervision using Behavioral Skills Training (BST). + Facilitate… more
    Child Communication and Behavior Specialists (08/30/25)
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  • Clinical Strategy Consultant

    Highmark Health (Camp Hill, PA)
    …as the clinical subject matter expert for clinical , quality, care, utilization , high cost claim and population health management as the part of the ... markets. The incumbent is primarily accountable for the delivery of clinical analysis and strategies for Highmark customers, including healthcare consultants and… more
    Highmark Health (08/26/25)
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