- Battelle Memorial Institute (Cannon AFB, NM)
- …with the referring provider, behavioral health consultant and/or psychiatry consultant + Perform case management functions **Key Qualifications** + Master ... and Analytics (HRA) business line is seeking a highly motivated, full-time **Licensed Clinical Social Worker (LCSW)** to join our team in support of our government… more
- The Joint Commission (Oakbrook Terrace, IL)
- …experience in the appropriate health care setting(s), and 2 years of senior management experience. Recent experience as a consultant to health care organizations ... pathways and in the identification and use of performance measures to improve clinical outcomes. Experience in chronic disease management is desirable. 5.… more
- The Joint Commission (Oakbrook Terrace, IL)
- …experience in the appropriate health care setting(s), and 2 years of senior management experience. Recent experience as a consultant to health care organizations ... pathways and in the identification and use of performance measures to improve clinical outcomes. Experience in chronic disease management is desirable. 1.… more
- The Joint Commission (Oakbrook Terrace, IL)
- …Operations (ACO) service teams in all aspects of the accreditation process through clinical expertise and customer relationship management . + Serves as a role ... provide high quality, safe patient care. Participates as a consultant in the development and revision of standards and...to assist in the development of corrective actions and utilization of Joint Commission tools. + Supports the entire… more
- Stanford Health Care (Palo Alto, CA)
- … management and prioritization.o Pursue lifelong learning to enhance clinical and professional knowledge.o Participate in department program planning, goal ... report to the Hospital Operations Manager. Preferred experience: - EMTALA Risk Management - Knowledge of insurance coverage - Transfer Center experience **This is… more
- Moses/Weitzman Health System (Meriden, CT)
- …component meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and ... licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or… more
- CVS Health (Phoenix, AZ)
- …about making a meaningful difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Frankfort, KY)
- …all with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant . **Must reside in the state of ... other internal and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide ... clinical insight into product development and testing as well...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Austin, TX)
- …**No travel is required.** As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare… more
- CVS Health (Austin, TX)
- …**No travel is required.** As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant ...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts ... education related to NICU and special populations utilization management . * Serve as a clinical resource on NICU care for internal and external partners.… more
- CVS Health (Harrisburg, PA)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area + Managed Care experience preferred, especially Utilization Management + Preference for those residing in ET and CT zones… more
- CVS Health (Austin, TX)
- …to work Monday through Friday, 10am to 7pm EST with occasional holiday rotation. Utilization Management is a 24/7 operation and work schedules will include ... holidays and evening hours.** + Utilizes clinical experience and skills in a collaborative process to...10:00am to 7:00pm eastern time with occasional holiday rotation. Utilization Management is a 24/7 operation and… more
- CVS Health (Phoenix, AZ)
- …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... role, you'll be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Key Qualifications + Strong clinical skills and understanding of HMM's Utilization Management , Case Management and operational procedures, Medical and ... colors to blue. The RoleThe Clinical Business Consultant for Cost and Trend Management is...attention. + Partner with Utilization and Care Management to provide clinical support and analysis… more
- Philips (Washington, DC)
- **National Fusion and Navigation Clinical Consultant - General Imaging Ultrasound (National Travel)** The GI National Fusion and Navigation Clinical ... on Philips Ultrasound platforms, building, maintaining, and providing outstanding technical and clinical product support, by being the consultant in multiple … more
- CVS Health (Austin, TX)
- …empowered to: + Deliver forward-thinking clinical insights derived from analyzing clinical utilization patterns and member behavior impact on medical costs. ... intellectual curiosity, desire for continuous learning and passion to improve population health. Clinical Program Consultant (CPC) plays a key role in delivering… more
- Elevance Health (Indianapolis, IN)
- ** Utilization Management Medical Director - Indiana Medicaid** **Location:** This role enables associates to work virtually full-time, with the exception of ... Internal Medicine, and Family Medicine specialties preferred. + 3-5 years of Utilization Management experience preferred. + Indiana license or the ability… more
- BD (Becton, Dickinson and Company) (San Jose, CA)
- **Job Description Summary** This position reports to the Associate Director of Clinical Support and supports the Specimen Management business unit. This role ... responsibilities will include:** + Fosters a continually evolving partnership between Specimen Management and our valued customers in a Clinical Process advisory… more
