• Utilization Management Nurse

    CVS Health (Austin, TX)
    …of the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant , you will utilize ... preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can… more
    CVS Health (01/01/26)
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  • Utilization Management Nurse

    CVS Health (Austin, TX)
    …of the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant , you will utilize ... all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live… 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 ... improvement, policy review, and education related to NICU and special populations utilization management . * Serve as a clinical resource on NICU care for… 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 ... 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 ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...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)
    …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… more
    CVS Health (12/13/25)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… more
    CVS Health (12/18/25)
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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 ... best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as...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 Clinical…

    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 (12/31/25)
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  • Utilization Mgmt Nurse RN - Care…

    Truman Medical Centers (Kansas City, MO)
    …time **Work Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse (UM RN) collaborates with members of the ... solving, and proficient organization and planning skills Preferred Qualifications: + Utilization Management experience + Experience with managed care,… more
    Truman Medical Centers (12/09/25)
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  • Quality Management Nurse

    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
    US Tech Solutions (01/05/26)
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  • Appeals Nurse Consultant (Remote)

    CVS Health (Columbus, OH)
    …heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant ** to join our remote team. In this role, you will be ... clinical experience. **Preferred Qualifications** + Appeals, Managed Care, or Utilization Review experience. + Pre Certification or Pre Authorization experience… more
    CVS Health (01/03/26)
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  • Clinical Business Consultant

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …concerns Key Qualifications + Strong clinical skills and understanding of HMM's Utilization Management , Case Management and operational procedures, Medical ... your true colors to blue. The RoleThe Clinical Business Consultant for Cost and Trend Management is...concerns that may require additional attention. + Partner with Utilization and Care Management to provide clinical… more
    Blue Cross Blue Shield of Massachusetts (12/19/25)
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  • Lactation Consultant RN - Mother/Baby

    Carle Health (Normal, IL)
    …Lactation Consultants (IBCLC) within 2 years - International Board of Lactation Consultant Examiners (IBCLE); Licensed Registered Professional Nurse (RN) - ... Overview The staff Registered Nurse (RN) is a professional caregiver who assumes...frame and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial… more
    Carle Health (11/14/25)
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  • Aetna Commercial Clinical Program…

    CVS Health (Austin, TX)
    …for continuous learning and passion to improve population health. Clinical Program Consultant (CPC) plays a key role in delivering strategic clinical insights to ... As a CPC, you will collaborate closely with account teams, care management , Regional Analytic Consulting, and key enterprise partners to support customer objectives.… more
    CVS Health (12/26/25)
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  • RN - Wound Ctr Inpatient Consultant

    Carle Health (Urbana, IL)
    …for a designated timeframe and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial, and human resources ... Heart Association (AHA)American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation… more
    Carle Health (11/04/25)
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  • Registered Nurse - Wound Ostomy

    Trinity Health (Mishawaka, IN)
    …for quality care. **JOB SUMMARY:** The inpatient **Certified Wound Ostomy Continency Consultant (CWOCN Consultant ), Registered Nurse ** will provide clinical ... and their family members to assist them in the management of their individual wound care needs. Ultimate responsibility...for the patient, unit based resource nurses and the Nurse Manager of each unit. The CWOCN Consultant more
    Trinity Health (12/08/25)
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  • Clinical Nurse -WoundCare-WOCN-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Job Title: Clinical Nurse -WoundCare-WOCN-Mount Sinai Hospital-FT/Days** The Nurse Clinician is a registered professional nurse who ... skills in an area of clinical nursing specialization. The nurse clinician is able to guide and promote the...Patient/Family education 3) D/C planning and follow-up 4) Case management 5) Research + Maintains clinical expertise in area… more
    Mount Sinai Health System (11/21/25)
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  • Nurse Case Manager: Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to ... appropriate LOS and financial constraints. + Provides collaborative care management with the primary nurse in assessing...assigned service - required + Recent experience in case management , utilization management and/or discharge… more
    Albany Medical Center (12/06/25)
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  • Registered Nurse Emergency Department

    Veterans Affairs, Veterans Health Administration (Salem, VA)
    …Come Join Our Team! The Salem Veterans Medical Center is seeking a Registered Nurse for the Emergency Department. Responsible and accountable for all elements of the ... patient care. The coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
    Veterans Affairs, Veterans Health Administration (01/04/26)
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