• Utilization Management

    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 (12/13/25)
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  • Utilization Management

    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
    CVS Health (12/31/25)
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  • Clinical Product Consultant

    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
    Waystar (11/21/25)
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  • Utilization Management Nurse…

    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 (01/01/26)
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  • Utilization Management Nurse…

    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 (01/01/26)
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  • Utilization Management Nurse…

    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 (01/03/26)
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  • Utilization Management Nurse…

    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 (01/03/26)
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  • Utilization Management Nurse…

    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 (12/28/25)
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  • Utilization Management Nurse…

    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
    CVS Health (12/13/25)
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  • Clinical Business Consultant

    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
    Blue Cross Blue Shield of Massachusetts (12/19/25)
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  • National Fusion and Navigation Clinical

    Philips (Lenexa, KS)
    **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
    Philips (01/07/26)
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  • Aetna Commercial Clinical Program…

    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
    CVS Health (12/26/25)
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  • Clinical Consultant - LA/Northern

    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
    BD (Becton, Dickinson and Company) (01/01/26)
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  • Utilization Review RN - Patient Bus Svs

    St. Peters Health (Helena, MT)
    The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR team members in ... collaborative and supportive liaison and educator to providers and staff around utilization management principles. This professional role will be responsible… more
    St. Peters Health (12/11/25)
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  • Compliance Consultant

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …us transform healthcare? Bring your true colors to blue. The Role:The Compliance Program Consultant will focus on utilization management compliance and audit ... + Bachelor's degree in clinical discipline required, 2 years of utilization management experience required; health insurance experience preferred + 1-2 years… more
    Blue Cross Blue Shield of Massachusetts (12/17/25)
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  • Specimen Management Consultant

    BD (Becton, Dickinson and Company) (Tempe, AZ)
    **Job Description Summary** The Specimen Management Consultant is responsible for selling the consumable product line (to include blood collection, safety ... AZ area are preferred **About the role:** The Specimen Management Consultant , SMC (Arizona & New Mexico),...sales calls to introduce novel solutions to customers through clinical insights, quality products and studies/tools to customers. +… more
    BD (Becton, Dickinson and Company) (12/13/25)
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  • Network Management Consultant

    Prime Therapeutics (Cheyenne, WY)
    …career? Come build the future of pharmacy with us. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more
    Prime Therapeutics (12/05/25)
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  • Consultant Analytical Engineer Expanse

    HCA Healthcare (Nashville, TN)
    Consultant Analytical Engineer partners closely with process engineers, clinical informatics, product teams, and enterprise stakeholders to uncover improvement ... Do you want to join an organization that invests in you as a Consultant Analytical Engineer Expanse? At HCA Healthcare, you come first. HCA Healthcare has committed… more
    HCA Healthcare (12/06/25)
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  • Manager - Contracts & Utilization

    Ochsner Health (Jefferson, LA)
    …This job manages expense management , vendor relationships, contract management , standardization and consolidation processes and utilization analysis. ... the organization by serving as a project manager and consultant to the clinical and non- clinical...utilization improvements. + Good judgment, organizational and time management skills. + Consulting and group presentation skills. +… more
    Ochsner Health (12/05/25)
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  • Quality Management Nurse Consultant

    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 ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
    US Tech Solutions (01/05/26)
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