- CVS Health (Columbus, OH)
- …and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical necessity, applies clinical expertise to assure ... employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- 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 ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… 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)
- …our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) ... unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents… more
- Kepro (Richmond, VA)
- …a vital partner for health solutions in the public sector. Acentra seeks a UM Reviewer & Appeals Coordinator RN (Remote within Virginia) to join our growing team. ... role - you will utilize clinical expertise for the review of medical records against appropriate criteria in conjunction with contract requirements, critical… more
- Kepro (Richmond, VA)
- …partner for health solutions in the public sector. Acentra seeks a Behavioral Health UM Clinical Reviewer RN to join our growing team. Job Summary: Our Clinical ... Reviewer RN will use clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements, critical thinking, and… 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 ... and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing):… 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 ... care more personal, convenient and affordable. This Utilization Management ( UM ) Nurse Consultant role is...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… 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 ... personal, convenient and affordable. Position Summary This Utilization Management ( UM ) Nurse Consultant role is...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… 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): ... personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is...- Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit… 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): ... personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is...-Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit… 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): ... personal, convenient and affordable. Position Summary: This Utilization Management ( UM ) Nurse Consultant role is...- Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit… 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 ... services to assure medical necessity, applies clinical expertise to assure appropriate benefit...Compact RN License or license in multiple states + UM Nurse Consultant experience +… 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
- 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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …senior leaders for decision making + Apply their clinical knowledge when assessing/auditing medical records and UM letters against medical necessity criteria ... of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual contributor while collaborating… 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 ... Walter Reed National Military Medical Center, Bethesda, Maryland. Full-time, Monday - Friday between...provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide… 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...on discharge needs/barriers for all patients; initiates intervention by UM Nurse as needed. Identifies need for… more
- Albany Medical Center (Albany, NY)
- …patient/significant others/family and payers by functioning as a clinician, consultant , advocate and educator for assigned service.The Case Manager participates ... patient/significant others/family and payers by functioning as a clinician, consultant , advocate and educator for assigned service. Principal Position… 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 ... Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays!** Medical /Dental/Vision, STD/LTD/Life, and Health Savings Account available!** Annual CME Stipend and… more