- Segal (Chicago, IL)
- …assure and measure the effectiveness of PBM and Healthcare company cost and utilization management programs and clinical services.Qualifications:| Minimum of ... pharmacy benefits data? This opportunity may be for you!Our Senior Consultant , Pharmacy Benefits Financial Analysis creates and analyzes pharmacy benefits financial… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of improving the health of our communities. About the Role:Job SummaryThe clinical informatics specialist (CIS) functions as a consultant , educator, and ... solutions to improve patient care.Knowledge and expertise in patient care management , clinical quality analytics, and value-based reimbursement/accountable care… more
- Cambia Health Solutions, Inc (Boise, ID)
- …authorization requests, reconsiderations, and appeals. Prepares reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing ... and other drug use issues which do not require clinical judgment. This function assists the Clinical ...to providers and members as necessary.Obtains and organizes drug utilization data, including patient specific and population-based data, in… more
- Adventist Health (Portland, OR)
- …assisting in collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, ... team and patient's healthcare benefactor to optimize outcomes. Serves as a consultant to the healthcare team on specific patient items. Job Requirements: Education… more
- Inova Health System (Fairfax, VA)
- …system. Assesses patient needs and coordination of multidisciplinary care. Serves as a clinical consultant to the health care team.- Coordinates a patient's plan ... resources. Acts as advisor/educator by providing emotional support, counseling, clinical education, resources and expert guidance to patients and families… more
- CVS Health (Frankfort, KY)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : + Licensed independent… more
- CVS Health (Richmond, VA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications : - Must have ... solutions to make health care more personal, convenient and affordable. Utilizes clinical experience and skills in a collaborative process to plan, implement,… more
- CVS Health (Bismarck, ND)
- …to 8:00pm EST zone (twice per month) Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience and skills ... 1+ year(s) of Med/Surg experience Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience + MedCompass… more
- CVS Health (Austin, TX)
- …convenient and affordable. Position Summary Precertification (Infertility): Utilization Management Nurse Consultant + Utilizes clinical experience ... needs + MS Office suites experience Preferred Qualifications + Precertification/ Utilization Management experience preferred + Infertility experience preferred… more
- CVS Health (Raleigh, NC)
- …membership of plan sponsor. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant ...to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical … more
- CVS Health (Columbus, OH)
- …can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all aspects ... to make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Harrisburg, PA)
- …expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... to make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Harrisburg, PA)
- …can live in Pennsylvania. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... to make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is 100% remote… more
- CVS Health (Plantation, FL)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical experience and skills ... (not all encompassing): -Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization , facilitates safe… more
- CVS Health (Columbus, OH)
- …and deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote ... EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Columbus, OH)
- …position and employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. You would be responsible...Consultant reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization ,… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+ years of ... care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA ISNP) Scheduled :… more
- CVS Health (Trenton, NJ)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. - Gathers clinical information and ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically… more
- CVS Health (Tallahassee, FL)
- …- 3+ years of clinical experience - Managed Care experience - Utilization management experience Education Associates degree required BSN preferred Pay Range ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- CVS Health (Columbus, OH)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... health care more personal, convenient and affordable. Position Summary + Utilizes clinical experience and skills in a collaborative process to assess, plan,… more
