- CVS Health (Lansing, MI)
- …full-time Utilization Management (UM) Nurse Consultant . As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... reviewing written clinical records. **Key Responsibilities of the UM Nurse Consultant ** (Includes but is not limited...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- CVS Health (Carson City, NV)
- …include weekend, evening and holiday rotations._ **Must reside in the PST zone** As a Utilization Management Nurse Consultant , you will utilize clinical ... Qualifications** - 2 years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (Harrisburg, PA)
- …all with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute… more
- CVS Health (Columbus, OH)
- …may include weekends, holidays and evening hours._ This is a full-time remote Utilization Management opportunity. + Utilizes clinical experience and skills in a ... + 3+ years of clinical experience as a Registered Nurse in a hospital setting including Medical/Surgical, Emergency room,...with a late shift rotation 10:30am to 7pm EST. Utilization management is a 24/7 operation. Work… more
- CVS Health (Columbus, 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 ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST or CST zones.… more
- CVS Health (Columbus, OH)
- …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 ... zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
- CVS Health (Kenner, LA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information...required - 5+ years of experience as a Registered Nurse - Must have active current and unrestricted LA… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with ... are not creditable as related degrees. Preferred Experience: 1 year Utilization Management experience preferred. Reference: For more information on… more
- CVS Health (Jackson, MS)
- …constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of ... years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. +… more
- CVS Health (Trenton, NJ)
- …a licensed Registered Nurse , any compact licensure must cover New Jersey** + Utilization Management is a 24/7 operation and the work schedule may include ... Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
- CVS Health (Baton Rouge, LA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** - Licensed… 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 ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… 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 ... + Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. **Skills:** + MUST HAVE… more
- Lincoln Financial (Columbus, OH)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- CVS Health (Springfield, IL)
- …Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** + Utilization Management review + Managed Care experience + Client processing ... required + Must reside in Illinois + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of residence. +… more
- CVS Health (Phoenix, AZ)
- …unrestricted state licensure required in state of residence **Preferred Qualifications** Utilization Management review Managed Care experience Client processing ... experience **Education** Registered Nurse **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 -… more
- CVS Health (Hartford, CT)
- …Health appeals. **Required Qualifications** * Must have active and unrestricted Registered Nurse (RN) licensure in state of residence * 3+ years clinical experience ... **Preferred Qualifications** * Appeals Experience * Managed Care Experience * Utilization review experience * Proficiency with computer skills including navigating… more
- Truman Medical Centers (Kansas City, MO)
- …time **Work Schedule** 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** ** Utilization Management Nurse (UM RN)** _Optimize Care. Improve Outcomes. ... 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
- 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: Full ... 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