- CVS Health (Topeka, KS)
- …experience including phone, computer, and clinical documentation systems + A Registered Nurse that must hold an unrestricted license in the state of Kansas, ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- Kepro (Richmond, VA)
- …for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (part-time) to join our growing team. Job Summary: Our Behavioral ... Management Clinical Reviewer will use clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements,… more
- CVS Health (Raleigh, NC)
- …(typically 1 holiday per year). There is no travel expected with this position. This UM Nurse Consultant position is part of Aetna's Commercial Care ... and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing):… more
- CVS Health (Trenton, NJ)
- … role is fully remote and employee can live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process ... populations - MCG experience - Managed care experience - UM Certification - MedCompass - 1+ year(s) of inpatient...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Columbus, OH)
- …health care more personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is fully remote and employee ... Time Holiday rotation 1-2 per year. CCR - Duals UM Nurse ConsultantUtilizes clinical experience and skills...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Harrisburg, PA)
- …and 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...- Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit… more
- CVS Health (Harrisburg, PA)
- …and 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...-Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit… more
- CVS Health (Plantation, FL)
- …Monday-Friday; 10:00 AM- 6:30 PM EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties include (not all encompassing): -Reviews ... services to assure medical necessity, applies clinical expertise to assure appropriate benefit...Compact RN License or license in multiple states + UM Nurse Consultant experience +… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan ... - Utilization Review experience preferred - Managed care experience - UM /CM/MCG Certification - Med Compass Experience Education Associates Degree required BSN… more
- CVS Health (Phoenix, AZ)
- …Eastern Time Shift. + Work with providers to secure information to complete medical necessity reviews for Oncology and Transplant related services. + MUST have the ... nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. + Position requires proficiency with computer… more
- CVS Health (Columbus, OH)
- …Will work with leadership for continual process improvement within Duals UM Program. Required Qualifications + RN with current unrestricted "multi-state privilege" ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- CVS Health (Trenton, NJ)
- …Medicare/Medicaid - Managed care (MCO) experience - Med Compass experience - CM/ UM Certification Education Associates Degree required BSN preferred Pay Range The ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual contributor while collaborating… 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 (DHO) at ... Walter Reed National Military Medical Center, Bethesda, Maryland. Full-time, Monday - Friday between...provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide… more
- Albany Medical Center (Albany, NY)
- …patient/significant others/family and payers by functioning as a clinician, consultant , advocate and educator for assigned service.The Case Manager participates ... patient/significant others/family and payers by functioning as a clinician, consultant , advocate and educator for assigned service. Principal Position… 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, CA** in ... Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays!** Medical /Dental/Vision, STD/LTD/Life, and Health Savings Account available!** Annual CME Stipend and… more
- University of Miami (Miami, FL)
- …Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% 1. Works closely with the medical director and the ... Cancer Center Sign-on Bonus: $25,000 T he Pediatric Chemotherapy Nurse will be a professional registered nurse ...clinic is well prepared consisting of all supplies and medical records (print and electronic) are up to date… more
- University of Miami (Miami, FL)
- …Non-exempt Employees Include Percent of Effort): Meets requirements of Clinical Trials Chemotherapy Nurse 50% Works closely with the medical director and the ... Center Sign-on Bonus: Up to $25,000 The Pediatric Chemotherapy Nurse will be a professional registered nurse ...clinic is well prepared consisting of all supplies and medical records (print and electronic) are up to date… 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 heroes, ... their families, and military retirees in the Medical Home Port at Naval Branch Health Clinic Mayport....Home Port at Naval Branch Health Clinic Mayport. Registered Nurse Case Manager is full-time position, 80 hrs/2 weeks.… more
- University of Miami (Miami, FL)
- …Up to $25,000 Meets requirements of Clinical Trials Senior Chemotherapy Nurse 30% Administers research study agents, standard chemotherapy and biotherapy agents, ... clinical protocol and clinical practice standards. Provides documentation to the Research Nurse and/or Data Manager. Meets study timelines and objectives as defined… more