- Northeast Georgia Health System, Inc (Oakwood, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia Health System is rooted in a foundation of improving the health ... of system-wide opportunities as they relate to Value Analysis standardization, utilization and implementation. Facilitate Value Analysis Teams (VAT) to most… more
- Blanchard Valley Hospital (Findlay, OH)
- …Manager is to develop, implement and evaluate an organized inpatient case management service for pediatric and adult hospitalized patients under the direction of ... committees and meetings to contribute information regarding transitions of care and utilization of care resources for the purpose of improving patient care and… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. **Position Summary** As a Utilization Management Nurse Consultant , you will utilize ... to coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible...times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all… more
- CVS Health (Austin, TX)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** ** Utilization Management is a 24/7 operation and work schedules may ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...experience with Microsoft Office applications (Outlook, Teams, Excel) + Utilization Management is a 24/7 operation and… more
- CVS Health (Columbus, OH)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a ... internal and external constituents in the coordination and administration of the utilization /benefit management function Function in a clinical telephone queue… more
- CVS Health (Phoenix, AZ)
- …and deliver solutions to make health care more personal, convenient and affordable. Utilization Management is a 24/7 operation and work schedule may include ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- CVS Health (Phoenix, AZ)
- …and external constituents in the coordination and administration of the utilization /benefit management function. - Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization - Consults and lends expertise to other internal...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
- CVS Health (New Albany, OH)
- …Following training, position is remote with occasional in office requirement.** Utilization Review - Precertification Nurse is responsible for telephonically ... assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's… more
- CVS Health (Columbus, OH)
- …Hours of operation/work schedule - M-F 8:00AM-5:00PM EST. As a Utilization Management (UM) Nurse Consultant , you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible...and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical… more
- Defense Health Agency (Fort Drum, NY)
- …for this Job Online (https://careers-civilianmedicaljobs.icims.com/jobs/8299/ nurse - consultant -%28referral- utilization ... is in this document (http://cpol.army.mil/employ/APF-JOA/Transcripts.pdf) . **Basic Requirement for Nurse Consultant (Referral Utilization ):** **Degree:** A… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 240830-5613FP-001 Location Middletown, CT Date Opened 9/5/2024 12:00:00 AM Salary ... Hospital - is accepting applications for one (1) full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) position, in… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, ... net required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse ...to develop and execute mitigation efforts. Serves as a consultant to the organization's Compliance team on an ad… more
- ERP International (Corpus Christi, TX)
- …executive staff, newcomers, as appropriate. * Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established ... **Overview** ERP International is seeking a **Registered Nurse (RN)** ** Utilization Manager** for a... Utilization Management (UM) standards of care. Assist… more
- Insight Global (New York, NY)
- Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance ... state the consultant resides in - 4-5 years of Remote Utilization Management experience at Payors, inpatient or outpatient - Proficiency using a MacBook -… more
- PruittHealth (Charlotte, NC)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required… more
- Defense Health Agency (Lackland AFB, TX)
- **Overview** Nurse Consultant Joint Base San Antonio Time to invest in some new footwear because if you're San Antonio-bound, you'd better _show up in boots_ ! ... and patient self-reported health surveys to identify improvement opportunities impacting demand management , disease, and utilization management . Reviews and… more
- US Tech Solutions (RI)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... + Must have experience with Medcompass + Must have prior authorization utilization experience. + Managed Care/Medicare experience preferred. **Skills:** + MUST HAVE… more
- Lincoln Financial Group (Columbus, OH)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization....will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information… more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is responsible for...external committees as delegated or assigned. Serves as a consultant to other departments or organizations as needed. Responsible… more
- SSM Health (WI)
- …Shift (United States of America) **Job Type:** Employee **Department:** 8746030033 Sys Utilization Management **Scheduled Weekly Hours:** 40 _SSM Health is an ... a calling** WI-REMOTE **Worker Type:** Regular **Job Highlights:** + **Department:** Utilization Review + **Schedule:** Full Time, Day Shift, 8:30am-5:00pm; every… more
