- CVS Health (Harrisburg, PA)
- …do it all with heart, each and every day. **Position Summary** Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, ... rounds * Assists with escalated case reviews/facility issues * Gathers clinical information and applies the appropriate clinical criteria/guideline, policy,… more
- CVS Health (Tallahassee, FL)
- …of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document ... and external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information and applies… more
- CVS Health (Carson City, NV)
- …rotations._ **Must reside in the PST zone** As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document ... and communicate all aspects of the utilization /benefit management program. - Utilizes clinical experience...Qualifications** - 2 years of experience as a Registered Nurse in adult acute care/critical care setting - Must… more
- CVS Health (Raleigh, NC)
- …may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document ... and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience...Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN… more
- CVS Health (Austin, TX)
- …operation. Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant you will be responsible for ... the review and evaluation of clinical information and documentation related to outpatient therapy services....to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- CVS Health (Harrisburg, PA)
- …heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization management ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience… more
- CVS Health (Boston, MA)
- …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active current ... zone.** This is a full-time remote position. + Utilizes clinical experience and skills in a collaborative process to...to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- CVS Health (Oklahoma City, OK)
- …work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, ... to facilitate appropriate healthcare services/benefits for members. + Gathers clinical information and applies the appropriate clinical criteria/guideline,… more
- PruittHealth (Columbia, SC)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… more
- Lincoln Financial (Washington, DC)
- …74628 **The Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be ... and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills… more
- Elevance Health (Wallingford, CT)
- **Wellness Nurse Consultant ** **_$5000 Sign-on Bonus._** _Location: This position is primarily based in Connecticut, with occasional presentations in Maine, and ... 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 (Salem, OR)
- …in time zone of residence **Monday - Friday.** **Position Summary** The Appeals Nurse Consultant position is responsible for processing the medical necessity of ... Primary duties may include, but are not limited to: Requesting clinical , research, extrapolating pertinent clinical , applying appropriate Medicare Guidelines,… more
- CVS Health (Annapolis, MD)
- …support to contracted Skilled Nursing (SNF) and Assisted Living (ALF) facilities. The Clinical Nurse Specialist/Infusion Educator for LTC (Long Term Care) will ... 8 hours of the work week are considered office days to plan visits. The Clinical Nurse Specialist/Infusion Educator LTC is responsible for the below, most of… more
- US Tech Solutions (RI)
- **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from ... clinical records or systems to apply appropriate ...have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. **Skills:** +… more
- CVS Health (Springfield, IL)
- …day. **Position Summary** Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained ... from clinical records or systems and uses clinical ...Illinois + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN… more
- Highmark Health (Richmond, VA)
- …Facing support **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical , quality, care, utilization , high-cost claim, and population health ... or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
- 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 ... through advanced knowledge and skills in an area of clinical nursing specialization. The nurse clinician is...as a consultant by: Serves as a consultant by: 1) Assisting clinical nurses and… more
- Veterans Affairs, Veterans Health Administration (Fargo, ND)
- …a real difference? Join the Fargo VA Health Care System as a Registered Nurse - Clinical Informatics. This RN-led role integrates nursing science with ... unrestricted license from any US State or territory The RN- Clinical Informatics Nurse will provide oversight and...Provide oversight of CPRS (Computerized Patient Record System) and clinical software applications. Serve as a consultant … more
- Tenet Healthcare (Detroit, MI)
- … Review for the designated Market. Will support the advancement of Centralized Utilization Review as a leader, mentor, and consultant . Will execute on ... Group Director Utilization Review - 2506000536 Description : The Detroit...status and level of care per Tenet policy Balances clinical and financial requirements and resources in advocating for… more
- Corewell Health (Big Rapids, MI)
- Job Summary The Clinical Nurse Specialist is an influential leader for a program or area of nursing practice. The advanced knowledge and skills required for this ... in the theory-based and/or research-based nursing practice within a specialty area. Clinical Nurse Specialists are REQUIRED to obtain their nursing… more