- CVS Health (Washington, DC)
- …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 (Washington, DC)
- …with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes clinical ... Time_ ). + Previous experience with prior authorization. + Previous experience with utilization management . + Previous experience in an acute care setting. +… more
- CVS Health (Annapolis, MD)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST zones **Anticipated Weekly… more
- CVS Health (Washington, DC)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Johns Hopkins University (Baltimore, MD)
- …guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland ... and the Nurse Practice Act of the State of Maryland. Is...long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to… more
- CareFirst (Baltimore, MD)
- …+ CCM - Certified Case Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** + 2 years medical-surgical or ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of...**Preferred Qualifications:** + 2 years experience in Medical Review, Utilization Management or Case Management … more
- CareFirst (Baltimore, MD)
- …+ CCM - Certified Case Manager Upon Hire Preferred. + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred. **Experience:** 5 years medical-surgical or ... similar clinical experience OR 5 years' experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross BlueShield, or similar… more