- CVS Health (Columbus, OH)
- …in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll play a ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Columbus, OH)
- …operation and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant ** Fully Remote- WFH **Schedule** - Mon-Fri 10:30AM-7PM with ... alternate weekends and holidays **Position Summary:** UM Nurse Consultant Utilizes clinical experience and skills...experience as an RN in the hospital setting - Utilization Management experience - Active and unrestricted… more
- CVS Health (Columbus, OH)
- …1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience + Must have active ... on the telephone, and type on the computer. **Preferred Qualifications** Utilization Management experience preferred **Education** Diploma RN acceptable;… more
- CVS Health (Columbus, OH)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST zones **Education**… more
- CVS Health (Columbus, OH)
- …health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care, ... education, connecting members to resources, and facilitating referrals to care management programs for continued support. This position supports the development and… more
- Trinity Health (Columbus, OH)
- …Minimum of 5 years acute care medical or surgical experience required;** ** Utilization /Case Management , managed care, or Clinical Documentation and experience ... of clinical documentation through the roles of reviewer, educator and consultant . Facilitates the overall quality, completeness, accuracy, and integrity of medical… more