- CVS Health (Carson City, NV)
- …be required 3 weeks training required 100% participation during 8:30am-5pm EST Monday-Friday As a UM Nurse Consultant you will work in a clinical telephone ... queue working with providers to secure additional information for prior authorization reviews. -This candidate will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. -Utilizes clinical… more
- CVS Health (Salem, OR)
- …will occasionally be required.Required Qualifications 1 year of varied UM (utilization management) experience within an inpatient/outpatient setting, concurrent ... ability to make thorough, independent decisions using clinical judgement. A Registered Nurse that must hold an unrestricted license in their state of residence,… more
- CVS Health (Montgomery, AL)
- …This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our ... purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors (TM) support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming… more
- CVS Health (Raleigh, NC)
- …(typically 1 holiday per year). There is no travel expected with this position. This UM Nurse Consultant position is part of Aetna's Commercial Care ... regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): -Reviews… more
- CVS Health (Columbus, OH)
- …9:30am-6:00 pm EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a ... to make health care more personal, convenient and affordable. This Utilization Management ( UM ) Nurse Consultant role is fully remote and employee can live in… more
- CVS Health (Springfield, IL)
- …9:30 am- 6:00 pm in EST zone with rotating weekends and holidays. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative ... care more personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is fully remote and employee can live… more
- CVS Health (Columbus, OH)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... care more personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is fully remote and employee can live… more
- CVS Health (Harrisburg, PA)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... care more personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is fully remote and employee can live… more
- CVS Health (Harrisburg, PA)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... care more personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is 100% remote and the candidate can… more
- CVS Health (Plantation, FL)
- …Monday-Friday; 10:00 AM- 6:30 PM EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties include (not all encompassing): -Reviews ... Spanish highly preferred + Compact RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas access to care +… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan ... - Utilization Review experience preferred - Managed care experience - UM /CM/MCG Certification - Med Compass Experience Education Associates Degree required BSN… more
- CVS Health (Columbus, OH)
- …highenergy and motivated team environment and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical necessity, ... home position and employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills to coordinate, document and communicate all… more
- Kepro (Richmond, VA)
- …partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer (PRN, Remote within Virginia) with an active RN, LCSW, LPC, ... join our growing team. Job Summary: Our Behavioral Health UM Clinical Reviewer (RN, LCSW,LPC, and/or LBA) will use...Determine approval or initiate a referral to the physician consultant and process physician consultant decisions, ensuring… more
- Veterans Affairs, Veterans Health Administration (Roseburg, OR)
- …with a focus on older adults and mental health. Acts as the Utilization Management ( UM ) nurse for the inpatient acute psychiatric unit. Tracks quality data for ... candidates VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases,...license from any US State or territory The QM Consultant , with a focus on geriatric and acute psychiatric… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual contributor while collaborating ... + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria and accreditation and regulatory criteria… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager to work the Directorate of Healthcare Operations (DHO) at ... two-week period will be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide the following services and… more
- Bassett Healthcare (Cooperstown, NY)
- …admission order and validates status and level of care matches order. Collaborates with UM Nurse to assure that all payor and status requirements are aligned ... align care team towards discharge goals. Serves as a consultant and educator with medical staff regarding status, placement,...on discharge needs/barriers for all patients; initiates intervention by UM Nurse as needed. Identifies need for… more
- ERP International (Camp Pendleton, CA)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position supporting **Branch Health Clinic Port Hueneme, CA** in ... and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. *… more
- The Arora Group (Mayport, FL)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse Case Manager in Mayport, Florida to provide care to active duty American heroes, ... retirees in the Medical Home Port at Naval Branch Health Clinic Mayport. Registered Nurse Case Manager is full-time position, 80 hrs/2 weeks. DUTIES OF THE RN CASE… more
- University of Miami (Plantation, FL)
- …. Location: Plantation Sign-on Bonus: Up to $25,000 The Chemotherapy nurse will be a professional registered nurse who will ... Employees Include Percent of Effort): Meets requirements of Chemotherapy Nurse Administers standard chemotherapy, research study agents and biotherapy agents,… more