- Battelle Memorial Institute (Sneads Ferry, NC)
- …with the referring provider, behavioral health consultant and/or psychiatry consultant + Perform case management functions **Key Qualifications** + Master ... and Analytics (HRA) business line is seeking a highly motivated, full-time **Licensed Clinical Social Worker (LCSW)** to join our team in support of our government… more
- Legend Biotech USA, Inc. (Atlanta, GA)
- …Affairs team. Direct education for healthcare professionals treating oncology patients on clinical data, adverse event management , and mechanism of action for ... between investigators and members of the Legend Biotech Medical Affairs and Clinical Development teams; Addressing AE management and education as… more
- Stanford Health Care (Palo Alto, CA)
- … management and prioritization.o Pursue lifelong learning to enhance clinical and professional knowledge.o Participate in department program planning, goal ... report to the Hospital Operations Manager. Preferred experience: - EMTALA Risk Management - Knowledge of insurance coverage - Transfer Center experience **This is… more
- Moses/Weitzman Health System (Meriden, CT)
- …component meeting client's health care needs. Participates with Community Health Center management in developing and achieving optimal clinical performance and ... licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or… 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 insight into product development and testing as well...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Raleigh, NC)
- …reside in CST or EST zone.** As a Utilization Management Nurse Consultant you will utilizes clinical experience and skills in a collaborative process to ... to facilitate appropriate healthcare services/benefits for members. + Gathers clinical information and applies the appropriate clinical ...Requirement to reside in EST or CST zone. + Utilization Management is a 24/7 operation and… more
- CVS Health (Raleigh, NC)
- …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- CVS Health (Lansing, MI)
- …Summary** Join our Utilization Management team as a Nurse Consultant , where you'll apply clinical judgment and evidence-based criteria to review ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- CVS Health (Columbus, OH)
- …of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current ... on the telephone, and type on the computer. **Preferred Qualifications** Utilization Management experience preferred **Education** Diploma RN acceptable;… more
- CVS Health (Columbus, OH)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, ... use of equipment experience including phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization... clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Trenton, NJ)
- …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, ... holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to...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 ... hours. This is a full-time, remote role. + Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and… more
- CVS Health (Harrisburg, PA)
- …of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current ... Nursing Licenses as business needs require. * **Preferred Qualifications** - Utilization Management experience preferred **Education** Associates Degree BSN… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...flexible Weekdays **Position Summary** Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for… more
- CVS Health (Austin, TX)
- … clinical experience in acute or post-acute setting,and 1+ years of Utilization Management / CareManagementExperience + Must have active current and ... obtainadditionalNursing Licenses as business needsrequire. * **Preferred Qualifications** - Utilization Management experience preferred - **Anticipated Weekly… more
- CVS Health (Hartford, CT)
- …of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active current ... additional Nursing Licenses as business needs require. **Preferred Qualifications** Utilization Management experience preferred **Education** Education: Diploma… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... it all with heart, each and every day. **Position Summary** + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Harrisburg, PA)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... are worked on the Saturday and Sunday. + 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 (Trenton, NJ)
- …and unrestricted RN licensure in New Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work ... Standard Time schedule** **Must be a licensed RN** + Utilization Management is a 24/7 operation and...and evening hours. + Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for… more
- CareFirst (Baltimore, MD)
- …**Experience:** 5 years experience in business development, operational technology support, Utilization Management (UM) operations, Clinical Product ... role will focus specifically on optimizing end-to-end business processes within Utilization Management . **ESSENTIAL FUNCTIONS:** + Provide deep subject matter… more
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