• Utilization Management

    CVS Health (Tallahassee, FL)
    …more personal, convenient and affordable. **Position Summary** This is a full-time remote Utilization Management Clinical Consultant opportunity for ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
    CVS Health (01/24/25)
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  • Utilization Management

    CVS Health (Frankfort, KY)
    …more personal, convenient and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant . **MUST RESIDE IN KENTUCKY** + ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Harrisburg, PA)
    …No travel is required. 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 (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    Consultant opportunity. 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 and skills in a collaborative process to assess, plan, implement,… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Raleigh, NC)
    …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 in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Richmond, VA)
    …to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% ... remote. As a Utilization Nurse Consultant , you will utilize clinical skills to...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    …may include weekends, holidays and evening hours._ This is a full-time remote Utilization Management opportunity. + Utilizes clinical experience and skills ... to facilitate appropriate healthcare services/benefits for members. + Gathers clinical information and applies the appropriate clinical ...with a late shift rotation 10:30am to 7pm EST. Utilization management is a 24/7 operation. Work… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Hartford, CT)
    …Qualifications** + Must reside within the Eastern or Central time zone + Utilization management is a 24/7 operation. Work schedules will include weekends ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Topeka, KS)
    …Friday 8:00 am to 5:00 pm CST with rotating late evening and weekend shifts. Utilization Management is a 24/7 operation and work schedule may include weekends, ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + Must reside in… more
    CVS Health (01/24/25)
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  • Utilization Management Nurse…

    CVS Health (Tallahassee, FL)
    …to make health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work schedules may include ... weekends and holidays and evening rotations. + Utilizes clinical experience and skills in a collaborative process to...may include weekends and holidays and evening rotations + Utilization management is a 24/7 operation. Work… more
    CVS Health (01/25/25)
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  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    …**Preferred Qualifications** + Clinical experience in post-acute setting + Prior utilization review or case management experience + Managed Care experience ... care more personal, convenient and affordable. **Position Summary** -Utilizes clinical experience and skills in a collaborative process to...or other events, as directed by their Leader. - Utilization Management is a 24/7 operation and… more
    CVS Health (01/25/25)
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  • Assistant Vice President - Clinical

    AON (IL)
    …currently have an exciting career opportunity for an Assistant Vice President, Clinical Consultant - Health Transformation within our National Health ... knowledge of the health market and industry, plans, case management , utilization management , vendors, special...an exciting career opportunity for an Assistant Vice President, Clinical Consultant - Health Transformation within our… more
    AON (01/23/25)
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  • RN Clinical Consultant , Claims…

    Guardian Life (Columbus, OH)
    **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
    Guardian Life (12/20/24)
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  • Consultant - Clinical Solutions,…

    Guidehouse (Chicago, IL)
    …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and health plan executives help healthcare organizations undertake cross-continuum clinical transformation efforts to generate sustained improvements in care access,… more
    Guidehouse (11/17/24)
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  • Senior Consultant - Clinical

    Guidehouse (Chicago, IL)
    …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and health plan executives help healthcare organizations undertake cross-continuum clinical transformation efforts to generate sustained improvements in care access,… more
    Guidehouse (11/17/24)
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  • Remote BCBA Supervisor & Clinical

    Child Communication and Behavior Specialists (CA)
    …and culturally inclusive environment. The Position We are seeking a Remote BCBA Supervisor & Clinical Consultant to join our team. This role is 100% remote with ... individualized, high-quality ABA programs. Key Responsibilities + Provide hands-on clinical supervision using Behavioral Skills Training (BST). + Facilitate… more
    Child Communication and Behavior Specialists (01/24/25)
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  • Clinical Transformation Consultant

    Highmark Health (Columbus, OH)
    …bachelor's degree + 5-7 years of experience in the healthcare industry (hospital clinical operations/ management , physician practice management or clinical ... that are required to accelerate the achievement of goals related to clinical operations excellence and optimal, sustained patient care (as manifested by patient… more
    Highmark Health (12/13/24)
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  • Medical Policy Clinical Researcher,…

    Guidehouse (Mclean, VA)
    Clinical credential (RN, MD, DO) is also acceptable + Experience with medical management ( utilization management , case management , disease ... Research:** Thoroughly researching, reviewing, and analyzing current medical literature, clinical practice guidelines, government regulations, and other sources to… more
    Guidehouse (01/09/25)
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  • RN, Utilization Review

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …RN required, Preferred Education: BSN preferred Experience: Greater than 3 years clinical nursing experience required. Utilization management experience ... and applies principles of utilization and quality management , and the management of clinical /financial resources as a facilitator and consultant to… more
    Chesapeake Regional Healthcare (01/25/25)
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  • Cardiovascular-Renal Sales Consultant

    Boehringer Ingelheim (San Diego, CA)
    **Description** The Cardiovascular-Renal Sales Consultant is responsible for partnering in developing and implementing a plan for brand sales growth of BIPI and ... and with BIPI guidelines, policies, and directives. The Cardiovascular-Renal Sales Consultant will conduct their business with key targeted healthcare providers… more
    Boehringer Ingelheim (12/11/24)
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