- CVS Health (Charleston, WV)
- …and more compassionate. And we do it all with heart, each and every day. ** Utilization Management Clinical Consultant ** **Remote - West Virginia** ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
- CVS Health (Baton Rouge, LA)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : + Licensed independent… more
- CVS Health (Columbus, OH)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
- CVS Health (Phoenix, AZ)
- …the lives of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven team that's ... Child Safety (DCS). + Knowledge of Behavioral Health Outpatient Services. + Utilization Management (UM) Experience. **Education** + Master's degree required for… more
- CVS Health (Baton Rouge, LA)
- …coverage required (as needed). 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 (Carson City, NV)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... 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 (Topeka, KS)
- …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 Central Time zones… more
- CVS Health (Trenton, NJ)
- …And 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 evening hours. * Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... to work 8-5pm local time. **Preferred Qualifications** + Prior authorization utilization experience preferred + Outpatient Clinical experience + Knowledge… 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
- CVS Health (Harrisburg, PA)
- …and other key enterprise partners to support our commercial plan sponsors. The Clinical Program Consultant fulfills the company mission of helping people on ... consultant is empowered to: + Provide progressive consultative clinical insights based on analysis of clinical ...consultative clinical insights based on analysis of clinical plan utilization and impact of member… 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
- Guidehouse (Chicago, IL)
- …per case, clinical variability) + Population health - healthcare cost, utilization and quality + Value-based care strategies + Strong understanding of healthcare ... insights to Guidehouse clients across various content domains (ie Clinical Operational Effectiveness, Population Health/Value-Based Care, Payer and Contracting,… 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
- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... quality regulations. The PA will act as a liaison between the CDI ( Clinical Documentation Improvement) professional, HIM (Health Information Management ) ,and… more
- Boehringer Ingelheim (Waco, TX)
- **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
- BD (Becton, Dickinson and Company) (San Antonio, TX)
- **Job Description Summary** The Specimen Management Consultant , SMC will sell existing and new BD IDS consumable products to include blood collection, safety ... sales calls to introduce novel solutions to customers through clinical insights, quality products and studies/tools to customers. +...and market expertise and educate the market on proper utilization and acceptance of BD product portfolio. + Keep… 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