• Utilization Management

    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 (05/15/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …anywhere in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant , you will utilize clinical skills ... we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and… more
    CVS Health (05/16/25)
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  • Utilization Management Nurse

    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 (05/15/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …every day. This is a full-time remote position. **Position Summary** Precertification (Infertility): Utilization Management Nurse Consultant + Utilizes ... 1+ years of MS Office suite experience **Preferred Qualifications** + Precertification/ Utilization Management experience + Infertility experience **Education** +… more
    CVS Health (05/17/25)
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  • Utilization Management Nurse

    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 ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in ET/CT zones.… more
    CVS Health (05/17/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …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, ... 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 (05/15/25)
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  • Utilization Management Nurse

    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
    CVS Health (05/09/25)
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  • Utilization Management Nurse

    CVS Health (Indianapolis, IN)
    …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm CST. Utilization management is a 24/7 operation. Work schedules will include a minimum ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
    CVS Health (05/07/25)
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  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …do it all with heart, each and every day. **Position Summary** This ** Utilization Manager** position is with Aetna's Long-Term Services and Supports (LTSS) team and ... is for candidates to hold a **New York Registered Nurse ** License. This employee will work four - 10...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience… more
    CVS Health (05/15/25)
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  • Utilization Management Clinical…

    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
    CVS Health (05/16/25)
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  • Senior Nurse Consultant - Columbia…

    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
    PruittHealth (04/18/25)
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  • Quality Management Nurse

    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
    US Tech Solutions (04/18/25)
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  • Consultant , Nurse Disability

    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
    Lincoln Financial (04/30/25)
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  • Infusion Educator - Nurse Consultant

    CVS Health (Annapolis, MD)
    …Skilled Nursing (SNF) and Assisted Living (ALF) facilities. The Clinical Nurse Specialist/Infusion Educator for LTC (Long Term Care) will work collaboratively ... of the work week are considered office days to plan visits. The Clinical Nurse Specialist/Infusion Educator LTC is responsible for the below, most of which must be… more
    CVS Health (05/16/25)
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  • Supervisor, Utilization Management

    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
    LA Care Health Plan (04/11/25)
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  • Group Director Utilization Review

    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
    Tenet Healthcare (04/20/25)
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  • Lactation Consultant - Birth Center

    Access Dubuque (Dubuque, IA)
    …degree nursing program.** **Active and current license for Registered Nurse ** **Active and current International Board-Certified Lactation Consultant ... Lactation Consultant - Birth Center **MercyOne** 1 Positions ID:...health and wellness, particularly as it relates to breastfeeding management and early parenting issues.** **Helps breastfeeding women and… more
    Access Dubuque (05/01/25)
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  • Certified Lactation Consultant - Family…

    McLaren Health Care (Lansing, MI)
    …the Patient Care Coordinator or Patient Care Manager, the Certified Lactation Consultant independently provides consultations to management for routine and ... or Practical Nurse by State of Michigan. * Certified Lactation Consultant (IBCLC) by the International Board of Lactation Consultant Examiners. * American… more
    McLaren Health Care (03/21/25)
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  • Senior Claims Consultant III- Virtual

    AON (New York, NY)
    National Healthcare Professional Liability -Senior Claims Consultant - Remote United States Job Responsibilities: Understanding client needs and programs + Identify ... and drive operational improvement for clients. + Improve client HPL claims management programs by examining and analyzing program elements and build best… more
    AON (04/23/25)
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  • Ops Registered Nursing Consultant

    MyFlorida (Miami, FL)
    OPS REGISTERED NURSING CONSULTANT - 64801869 Date: May 15, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 850863 Agency: Department of Health Working Title: OPS REGISTERED NURSING CONSULTANT - 64801869 Pay Plan: Temp Position Number: 64801869 Salary: $47.00 hourly… more
    MyFlorida (05/15/25)
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