- CVS Health (Raleigh, NC)
- …operation and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant , you will utilize clinical ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
- CVS Health (Carson City, NV)
- …that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key ... 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 (Concord, NH)
- …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 EST zones.… more
- CVS Health (Denver, CO)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a… more
- CVS Health (Austin, TX)
- …applications (Outlook, Teams, Excel) **Preferred Qualifications** + Prior authorization or Utilization Management experience + Managed care experience + ... internal and external constituents in the coordination and administration of the utilization /benefit management function. **_Please note: This is a full time… more
- CVS Health (Charleston, WV)
- …more compassionate. And we do it all with heart, each and every day. ** Utilization Management Clinical Consultant ** **Remote - West Virginia** Schedule is ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
- CVS Health (Columbus, OH)
- …day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out of ... clinical 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)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : + Licensed independent… more
- CVS Health (Columbus, OH)
- …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 independent… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …an independent manner with little or no direct supervision. Serves as a consultant on Utilization Management and Performance Improvement Initiatives. Assists ... (VAGLAHS) is seeking to hire experienced Registered Nurses to work in our Utilization Management (UM) Program. Incumbents are expected to perform assessing,… 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 (Raleigh, NC)
- …9:00 PM EST approximately quarterly **Job Descriptions** The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and ... Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits… more
- CVS Health (Raleigh, NC)
- …be required per business needs, approximately quarterly The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and ... -Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits… more
- CVS Health (Hartford, CT)
- …**Preferred Qualifications** + Appeals Experience + Managed Care Experience + Utilization review experience + Proficiency with computer skills including navigating ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… 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
- 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
- Houston Methodist (Baytown, TX)
- At Houston Methodist, the Lactation Support Consultant position functions at the Proficient level according to Benner's model of clinical practice and is responsible ... breast feeding support under the general supervision of the Nurse Director. In addition to functioning as a staff... Director, Managers and Charge Nurses, the Lactation Support Consultant position is responsible for the quality of patient… more
- MyFlorida (Orlando, FL)
- …Bachelor's Degree in any other discipline with at least 6 months of direct case management experience or a Florida Licensed Registered Nurse (RN) with 1-year of ... HUMAN SERVICES PROGRAM CONSULTANT II - 64006362 Date: Jun 4, 2025...(CBO's). Incumbent reports directly to the Supervisor of Case Management . Staff will establish and maintain a caseload of… more
- CVS Health (Harrisburg, PA)
- …to customer data analysis. Working proactively with the account team, Care management teams, peers, and other key enterprise partners to support our commercial ... plan sponsors. The Clinical Program Consultant fulfills the company mission of helping people on...consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... and Family Treatment Center includes occasionally accompanying patients outdoors. Management of confused/disoriented and combative patients may involve tasks which… more