- CVS Health (Columbus, 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 (Carson City, NV)
- …reside in the PST zone** As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. - Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Austin, TX)
- …operation. Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant you will be responsible for ... the review and evaluation of clinical information and documentation related to outpatient therapy services....work Monday through Friday 8:00am to 5pm CST + Utilization management is a 24/7 operation. Work… more
- CVS Health (Harrisburg, PA)
- …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 EST zones **Education**… more
- Guardian Life (Bismarck, ND)
- **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
- Guidehouse (Chicago, IL)
- …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and operational improvement across business and purchased services, supply cost, and clinical supply utilization at client provider organizations. Our team of… more
- Houston Methodist (Houston, TX)
- …Center for Performing Arts Medicine. At Houston Methodist, the Speech Pathologist (SP) Clinical Consultant position is responsible for functioning as a licensed ... and acuities on an outpatient basis. As an experienced Therapist, the SP Clinical Consultant position provides education to patients, patient's family members… more
- 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
- Highmark Health (Richmond, VA)
- …+ Deep Clincal Expertise -extensive knowledge of clinical , quality, care, utilization , high-cost claim, and population health management . Must be a ... Description :** **JOB SUMMARY** This job serves as the sales team's clinical expert, providing high-level support and insights for strategic clients, aligning… more
- Ochsner Health (New Orleans, LA)
- …at Ochsner Health and discover your future today!** The Physician Advisor (PA- Utilization Management ) serves as the physician leader in matters relating ... the Interdisciplinary and Post-Acute teams, Payors, Administration and Revenue Cycle) to improve utilization management , sustain quality goals, and act as a … more
- UPMC (Pittsburgh, PA)
- …with hospital administration and clinical teams. + Experience in utilization management and care coordination. + In-depth understanding of regulatory ... The Regional Medical Director, CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This… 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: ... 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
- Boehringer Ingelheim (Sacramento, CA)
- **Description** The Cardiovascular-Renal Sales Consultant is responsible for partnering in developing and implementing a plan for brand sales growth of BIPI and ... and with BIPI guidelines, policies, and directives. The Cardiovascular-Renal Sales Consultant will conduct their business with key targeted healthcare providers… 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 ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
- Trinity Health (Pontiac, MI)
- …including senior management . + Proficiency with or ability to learn clinical information systems supporting PRM (Physician Relationship Management tools) + ... access, service and other operational issues identified by surgeons that inhibit utilization of and referrals to Trinity Health facilities, physicians, and services.… more
- Penn Medicine (Philadelphia, PA)
- …Research with a focus on supply chain, patient throughput, resource allocation and utilization , queuing theory and capacity management to help optimize business ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- J&J Family of Companies (Boston, MA)
- …more at https://www.jnj.com **Job Function:** MedTech Sales **Job Sub** **Function:** Clinical Sales - Surgeons (Commission) **Job Category:** Professional **All Job ... are searching for the best talent for a Sales Consultant Foot & Ankle to support clients in the...than 6 million people moving each year while delivering clinical and economic value to surgeons and healthcare systems.… 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 ... responsible for planning and directing clinical operations and quality improvement practices for designated centers. The senior nurse consultant provides… more
- Adelante (Phoenix, AZ)
- …degree Job Category Health Care Description POSITION SUMMARY The Behavioral Health Consultant is responsible for the management of psychosocial aspects of ... Behavioral Health Consultant Job Details Job Location Adelante Healthcare Roosevelt...and encourages personal responsibility for health. Provides consultation and co- management in the co-treatment of mental disorders and psychosocial… more