- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,… more
- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and… more
- CVS Health (Columbus, OH)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... and external constituents in the coordination and administration of the utilization /benefit management function.Required Qualifications* 3+ years of experience… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+ years of… more
- CVS Health (Lansing, MI)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a...external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+… more
- Insight Global (New York, NY)
- …here https://www.nursys.com/LQC/LQCTerms.aspx and send to me with QB - 4-5 years of Remote Utilization Management experience at Payors, inpatient or ... Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance… more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ... for UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with all departments to… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...change based on business needs + This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Montgomery, AL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Hours are Monday-Friday 8am-5pm EST/CST + This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- University of Washington (Seattle, WA)
- Req #: 228720 Department: HARBORVIEW - UTILIZATION MANAGEMENT Posting Date: 05/03/2024 Closing Info: Open Until Filled Salary: $7375 - $13,396 per month Shift: ... benefits for this position, click here (https://hr.uw.edu/benefits/wp-content/uploads/sites/3/2018/02/benefits-summary-classified-staff-greater-than-half-time-20220908\_a11y.pdf) . RN2, Utilization Management Specialist. This is a hybrid… more
- CVS Health (Baton Rouge, LA)
- …Required Qualifications + 5+ years of clinical experience + 1+ year(s) of utilization management , concurrent review and/or prior authorization experience + 5+ ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in… more
- CVS Health (Columbus, OH)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a ... internal and external constituents in the coordination and administration of the utilization /benefit management function Function in a clinical telephone queue… more
- CVS Health (Lansing, MI)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit ... to make health care more personal, convenient and affordable. Position Summary Fully remote Work from home anywhere in the US. Working hours will be Monday-Friday… more
- CVS Health (High Point, NC)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... solutions to make health care more personal, convenient and affordable. Fully remote . Position Summary + Utilizes clinical experience and skills in a collaborative… more
- CVS Health (Phoenix, AZ)
- …and services both inpatient and outpatient services requiring precertification. + Utilization Management nurses use specific criteria to authorize ... care more personal, convenient and affordable. Position Summary 100% remote position from anywhere in the US Work hours:...100% participation during 8:30am-5pm Monday-Friday EST. + A Registered Nurse that must hold an unrestricted license in their… more
- CVS Health (Trenton, NJ)
- …rotation per business needs Preferred Qualifications - Prior authorization & utilization management experience - Outpatient Clinical experience - Knowledge ... internal and external constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit… more
- Geisinger (Danville, PA)
- …with decision making and documentation processes. + Works with staff and management team to support recommendations for high risk members to improve transitions ... + Assesses and recommends policies as they relate to readmissions and utilization review activities. + Reviews inpatient level of care and readmission trends… more
- CVS Health (Sandy, UT)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+ years of… more
- ERP International (Vandenberg AFB, CA)
- **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Utilization Management ** in support of the30th Medical Group at Vandenberg AFB, ... CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/ Remote Practice Opportunity.** **Be the Best!** Join our team… more
- Ascension Health (Minooka, IL)
- …and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification ... specifics._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning, and utilization review. + Review… more