- 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 (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 (Madison, WI)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- …care healthcare settings. Knowledge and ability to apply InterQual criteria, utilization management process, clinical documentation requirements, current ... Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental...criteria to perform basis review while developing technical and clinical competencies. The Nurse is a novice with limited… more
- CVS Health (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management (UM) Nurse Consultant is a remote, full-time role ... external stakeholders. The position also involves coaching healthcare staff on utilization management principles and contributing to policy development.… more
- CVS Health (Albany, NY)
- …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... Qualifications** + Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or Nursing Diploma… more
- CVS Health (Indianapolis, IN)
- …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 zones… more
- Sanford Health (Bemidji, MN)
- …of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently holds ... or coordinates education to all internal customers related to compliance, coding, and clinical documentation issues and acts as a consultant to coders when… 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
- 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
- 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
- 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
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Quality & Patient Safety Nurse Manager - Utilization Management functions as a clinical expert and is responsible and ... visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: 1-3 years Utilization Management , Nurse Case Manager/Caseworker, and/or Process Improvement Consultant… 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
- Prime Therapeutics (Salt Lake City, UT)
- …fuels our passion and drives every decision we make. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more