- CVS Health (Columbus, OH)
- …EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process ... care more personal, convenient and affordable. This Utilization Management ( UM ) Nurse Consultant role is...3+ years of experience as a Registered Nurse + Must hold active and unrestricted RN… more
- CVS Health (Lansing, MI)
- …is fully remote and employee can live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to ... options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- CVS Health (Harrisburg, PA)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is...state of residence - 3+ years of acute hospital clinical experience as an RN - Must… more
- CVS Health (Harrisburg, PA)
- …state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): - ... personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is...reside in Pennsylvania - 3+ years of acute hospital clinical experience as an RN with preference… more
- Kepro (Richmond, VA)
- …Local law. Requirements Required Qualifications/Experience: + Active unrestricted Registered Nurse ( RN ) license, Licensed Clinical Social Worker (LCSW) ... join our growing team. Job Summary: Our Behavioral Health UM Clinical Reviewer ( RN , LCSW,LPC,...Determine approval or initiate a referral to the physician consultant and process physician consultant decisions, ensuring… more
- CVS Health (Columbus, OH)
- …attend the first 3 weeks training required 100% participation during 8:30am-5pm Monday-Friday.A Registered Nurse that must hold an unrestricted license in their ... 1 year UM , concurrent review or prior authorization5 years of clinical experience required5 years Demonstrated to make thorough independent decisions using … more
- CVS Health (Salem, OR)
- …or long-term care. 5 years demonstrated ability to make thorough, independent decisions using clinical judgement. A Registered Nurse that must hold an ... information required for prior authorization review. They may also work in a clinical call que to obtain this information. This candidate will utilize clinical… more
- CVS Health (Phoenix, AZ)
- …3 weeks training required 100% participation during 8:30am-5pm Monday-Friday EST. + A Registered Nurse that must hold an unrestricted license in their state ... coverage (URAC and Client Requirements). + Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for treatment and… more
- CVS Health (Springfield, IL)
- …Monday-Friday 8am- 5:30 pm Central Standard Time. Weekend/Holiday Rotation Utilizes clinical experience and skills in a collaborative process to assess, plan, ... options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- CVS Health (Montgomery, AL)
- …of the utilization/benefit management function. Required Qualifications3+ years of acute care clinical experience as RN RN with current unrestricted ... time shift. Weekend/holiday coverage will occasionally be required Work in clinical telephone queue working with providers to secure additional information for… more
- CVS Health (Columbus, OH)
- …Pay: Bi-weekly. No shift premium. Occasional Overtime may be required. Utilizes clinical experience and skills in a collaborative process to implement, coordinate, ... monitor and evaluate medical review cases . Applies the appropriate clinical criteria/guideline to render a medical determination to the client. Applies critical… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse ( RN ) Case Manager to work the Directorate of Healthcare Operations ... be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER ( RN ):...Manager Certified (CMC) + Experience: + Referral Management/Utilization Management (RM/ UM ) experience. + Clinical subspecialty experience in… more
- Bassett Healthcare (Cooperstown, NY)
- …Recently named a Forbes America's Best-In-State Employer 2022! What you'll do The Unit Clinical Care Coordinator Registered Nurse acts a principle liaison ... as needed. Identifies need for patient to receive IM letter; collaborates with UM Nurse as needed. Assists Clinical Documentation Specialist in engaging… more
- The Arora Group (Mayport, FL)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse Case Manager in Mayport, Florida to provide care to active duty American ... Medical Home Port at Naval Branch Health Clinic Mayport. Registered Nurse Case Manager is full-time position,...Certified Rehabilitation Counselor (CRC) + American Nurses Credentialing Center Nurse Case Manager ( RN -NCM) + National Academy… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager** for a full-time position supporting **Branch Health Clinic Port Hueneme, ... Credentialing Center (ANCC). Licensure:** Current, full, active and unrestricted license as a Registered Nurse Security** : Must possess ability to pass a… more
- University of Miami (Plantation, FL)
- …Bonus: Up to $25,000 The Chemotherapy nurse will be a professional registered nurse who will administer standard chemotherapy and biotherapy agents, research ... Provides patient/family teaching using available resources and tools. Acts as consultant to clinical staff in assisting with unfamiliar procedures/treatments.… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …QI techniques and theory What You Bring: + Active and Unrestricted Massachusetts Registered Nurse license required + Bachelor's degree in healthcare or related ... of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence...to senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM… more
- CVS Health (Plantation, FL)
- …Spanish highly preferred + Compact RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas access to care + ... EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties...dynamics of clinical staff and patients. Education Registered Nurse : Diploma, Associates degree in Nursing… more
- LA Care Health Plan (Los Angeles, CA)
- …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Utilization Management RN (Outpatient) Job Category: Clinical Department:...that purpose. Job Summary The Supervisor of Utilization Management ( UM ) RN is responsible for executing the… more
- CVS Health (Columbus, OH)
- …highenergy and motivated team environment and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical necessity, ... employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical...residence - Minimum of 3 years of acute hospital clinical experience as an RN - Must… more