- CVS Health (Austin, TX)
- …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 (Baton Rouge, LA)
- …Schedule is Monday-Friday, 8AM-5PM CST with weekend/holiday coverage required (as needed). As a Utilization Management Nurse Consultant , you will utilize ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience...Qualifications** + 3+ years of experience as a Registered Nurse in a clinical setting. + Must have active… more
- CVS Health (Lansing, MI)
- …and more compassionate. And we do it all with heart, each and every day. ** Utilization Management Nurse Consultant ** Fully Remote- WFH **Position ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… 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 (Lansing, MI)
- …include weekends, holidays, and evening hours._ _Weekends: F/S/S/M 10 hour shifts_ **UM Nurse Consultant ** Fully Remote- WFH **Position Summary** UM Nurse ... Consultant Position Summary: UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate,… 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 ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
- CVS Health (Salt Lake City, UT)
- …procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to ... meet quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3+ Years of...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- Veterans Affairs, Veterans Health Administration (Leeds, MA)
- Summary This Registered Nurse position is in Nursing Service at the VA Central Western Massachusetts Healthcare System, located in Leeds, Ma. This is a full time 40 ... of healthcare services. Collaborate with multidisciplinary teams to ensure proper utilization of healthcare resources. Develop and implement UM policies and… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant . **Must reside in the state of Kentucky or ... and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate,… 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
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator Office/On-site Recruitment # 250910-5613FP-001 Location East Hartford, CT Date Opened 9/15/2025 12:00:00 AM Salary $86,261 - ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …matter expert for controlled substance management . Responsibilities The Nurse Controlled Substance Coordinator (CSC) Consultant executes position ... responsibilities that demonstrate leadership, experience, and creative approaches to the management program aspects. The CSC Consultant is responsible for the… 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 (Hartford, CT)
- …do it all with heart, each and every day. **Position Summary** The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... providers. This role is considered a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include, but are not limited… 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 (Houston, 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: Aug 30, 2025...(CBO's). Incumbent reports directly to the Supervisor of Case Management . Staff will establish and maintain a caseload of… more
- CVS Health (Oklahoma City, OK)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** : + Unrestricted… more
- Highmark Health (Camp Hill, PA)
- …+ Performs as the clinical subject matter expert for clinical, quality, care, utilization , high cost claim and population health management as the part ... stay current on health, wellness, productivity, risk and care management trends in the market place in order to...or CERTIFICATIONS** **Required** (any of the following) + Registered Nurse (RN) + Physician Assistant License - PA +… more