- CVS Health (Columbus, OH)
- …in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll play a ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Columbus, OH)
- …and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant ** Fully Remote- WFH Schedule: W/Th/F/Sa (4-10hr shifts) **Position ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 3+ years of… more
- CVS Health (Columbus, OH)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... + 3+ years of clinical experience as a Registered Nurse in a hospital setting in adult acute care/critical...or specialty area + Managed Care experience preferred, especially Utilization Management + preference for those residing… more
- CVS Health (Columbus, OH)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- CVS Health (Columbus, OH)
- …health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care, ... education, connecting members to resources, and facilitating referrals to care management programs for continued support. This position supports the development and… more