- CVS Health (Austin, TX)
- … role is 100% remote and the candidate can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse ...times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all… more
- CVS Health (Raleigh, NC)
- …do it all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- CVS Health (Columbus, OH)
- …in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll play a ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Lansing, MI)
- …that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant , where you'll apply ... 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 (Harrisburg, PA)
- …we do it all with heart, each and every day. **Position Summary** This Registered Nurse Utilization Management position is an exciting opportunity to join a ... current review stays. **Primary Job Duties & Responsibilities** Drives effective utilization management practices by ensuring appropriate and cost-effective… more
- CVS Health (Columbus, OH)
- …and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant ** Fully Remote- WFH Schedule: W/Th/F/Sa (4-10hr shifts) **Position ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 3+ years of… more
- CVS Health (Harrisburg, PA)
- …and more compassionate. And we do it all with heart, each and every day. Utilization Management is a 24/7 operation and work schedule may include weekends, ... + 3+ years clinical practice experience as a Registered Nurse preferably in an acute setting (ex: OR, ER,...and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and… more
- CVS Health (Trenton, NJ)
- …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 ET and CT zones… more
- 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 (Carson City, NV)
- …heart, each and every day. **Must Reside in PST Time Zone** **Position Summary** Utilization Management is a 24/7 operation and work schedules will include ... Zone + 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 (Springfield, IL)
- …3+ years of clinical practice experience in an inpatient setting as an RN - Utilization management is a 24/7 operation. Work schedules may include weekends and ... holidays and evening rotations. **Preferred Qualifications** -Previous Utilization Management experience **Education** Associate degree required; BSN preferred… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… more
- CVS Health (Richmond, VA)
- …state of residence. 1+ years of clinical experience **Preferred Qualifications** Utilization Management experience Managed Care Experience Proficiency in grammar ... services. Maintains accurate and complete documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical ... best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Raleigh, NC)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- CVS Health (Oklahoma City, OK)
- …health setting required. + Strong knowledge of clinical practice guidelines and utilization management . **Required** **Qualifications** : + Unrestricted OK state ... your clinical skills to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply critical thinking and… more
- Veterans Affairs, Veterans Health Administration (Fort Harrison, MT)
- Summary The Registered Nurse (RN) Quality Management (QM) Performance Measures Consultant will function as an advanced clinician and execute position ... management activities. Provide program oversight and coordination in quality, utilization , and performance management processes by assisting with performance… more
- Elevance Health (Cincinnati, OH)
- **Wellness Nurse Consultant ** **Sign on Bonus: $5000** **Field:** This field-based role enables associates to primarily operate in the field, traveling to client ... and together we will drive the future of health care. The **Wellness Nurse Consultant ** position is responsible for developing and recommending customized,… 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
- CVS Health (Austin, TX)
- …in managed care, clinical, or health care related field. - 1 year of project management experience. - Registered Nurse (RN) license in the state of their ... in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides training and… more