- CVS Health (Olympia, WA)
- …need of the department. There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills ... all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in PST… more
- CVS Health (Columbus, OH)
- …will include weekends and holidays and evening rotations._ This is a full-time remote Utilization Management Nurse Consultant opportunity. As a ... Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization… more
- CVS Health (Albany, NY)
- …And we do it all with heart, each and every day. **Position Summary:** This Utilization Management Nurse Consultant (UMNC) position is a work ... in the event of a clinical audit. As a Utilization Nurse Consultant , you will...to coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible… more
- CVS Health (Columbus, OH)
- …of time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and… 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, ... Qualifications** **- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting** **- Must...and unrestricted RN licensure in state of residence** **- Utilization Management is a 24/7 operation and… more
- CVS Health (Raleigh, NC)
- …or 9:00am to 6:00pm in time zone of residence with occasional holiday rotation. Utilization Management is a 24/7 operation and work schedules will include ... holidays and evening hours **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience + Experience using… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST or CST zones… more
- CVS Health (Tallahassee, FL)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization management is a 24/7 operation. Work schedules will include weekend, ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST or CST zones -… more
- CVS Health (Tallahassee, FL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days...their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3+ years of… more
- CVS Health (Carson City, NV)
- …and external constituents in the coordination and administration of the utilization /benefit management function. - Typical office working environment with ... do it all with heart, each and every day. **Position Summary** _Utilization management is a 24/7 operation. Work schedules will include weekend, evening and holiday… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- CVS Health (Baton Rouge, LA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** - Licensed… more
- Defense Health Agency (Oceanside, CA)
- …will serve as a Supervisory Nurse and be responsible for the integration of Utilization Management , Case Management , and Disease Management based on ... **Overview** **Supervisory Nurse ( Consultant )- GS-0610-12 - Camp Pendleton,... Management Model. + Implement and monitor the Utilization Management Program. + Develop, implement, and… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- Summary The Clinical Nurse Consultant is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient ... the least restrictive, most cost-effective manner, through use of outpatient utilization management criteria, clinical practice guidelines and clinical pathways.… more
- PruittHealth (Savannah, GA)
- **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
- 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
- CVS Health (Springfield, IL)
- …Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** - Utilization Management review - Managed Care experience - Client processing ... years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in state of residence… more
- CVS Health (Tallahassee, FL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a… more
- Louisiana Department of State Civil Service (Jackson, LA)
- …from nurses of a lower level by the presence of serving as a Statewide Nurse Consultant . Differs from RN Regional Manager by the absence of direct supervision ... In collaboration with the higher level nursing administrators and Regional Nurse Consultants, provides guidance concerning nursing management of public… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical information ... Summary The Utilization Review Nurse combines clinical expertise...Experience: Greater than 3 years clinical nursing experience required. Utilization management experience preferred. Must be self-directed… more