- MedStar Health (Washington, DC)
- …timeframe. ADMINISTRATIVE: Assumes formally designated resource role for colleagues in unit management . ADMINISTRATIVE: Acts as a consultant for nursing staff in ... needs range from uncomplicated to highly complex. Receives supervision from the Nurse Leader and functional supervision from the clinical coach/designee. May at… more
- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... health care activities as agreed, eg school based clinic consultant , SNF care. Administrative Maintains board certification/licensure. Attends continuing education… more
- CVS Health (Austin, TX)
- … role is 100% remote and the candidate can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse ...times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all… more
- CVS Health (Harrisburg, PA)
- …all with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute… more
- CVS Health (Columbus, OH)
- …operation and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant ** Fully Remote- WFH **Schedule** - Mon-Fri 10:30AM-7PM with ... alternate weekends and holidays **Position Summary:** UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan,… more
- CVS Health (Charleston, WV)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** ** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** **- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting** **- Must...and unrestricted RN licensure in state of residence** **- Utilization Management is a 24/7 operation and… more
- CVS Health (Carson City, NV)
- …heart, each and every day. **Must Reside in PST Time Zone** **Position Summary** Utilization Management is a 24/7 operation and work schedules will include ... Zone + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting. + Must...and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and… more
- 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 (Albany, NY)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management opportunity for RNs with a **New York** state licensure. ... 8:30am - 5pm EST. This role is a registered nurse that utilizes MCG rules and applies medical necessity...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience… more
- CVS Health (Trenton, NJ)
- …a licensed Registered Nurse , any compact licensure must cover New Jersey** + Utilization Management is a 24/7 operation and the work schedule may include ... Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
- CVS Health (Richmond, VA)
- …state of residence. 1+ years of clinical experience **Preferred Qualifications** Utilization Management experience Managed Care Experience Proficiency in grammar ... services. Maintains accurate and complete documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally… 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 ... 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
- CVS Health (Raleigh, NC)
- …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 (Oklahoma City, OK)
- …health setting required. + Strong knowledge of clinical practice guidelines and utilization management . **Required** **Qualifications** : + Unrestricted OK state ... your clinical skills to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply critical thinking and… more
- Veterans Affairs, Veterans Health Administration (Prescott, AZ)
- Summary Northern Arizona VA Health Care System is looking for a Registered Nurse - Utilization Management to join the Quality & Patient Safety team! ... include, but are not limited to: The Utilization Management Coordinator (UMC) is a registered professional nurse who serves as a consultant to the… more
- 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
- Elevance Health (Cincinnati, OH)
- **Wellness Nurse Consultant ** **Sign on Bonus: $5000** **Field:** This field-based role enables associates to primarily operate in the field, traveling to client ... and together we will drive the future of health care. The **Wellness Nurse Consultant ** position is responsible for developing and recommending customized,… more
- CVS Health (Austin, TX)
- …in managed care, clinical, or health care related field. - 1 year of project management experience. - Registered Nurse (RN) license in the state of their ... in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides training and… more
- CVS Health (Hartford, CT)
- …**Preferred Qualifications** * Appeals Experience * Managed Care Experience * Utilization review experience * Proficiency with computer skills including navigating ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
