- CVS Health (Olympia, WA)
- …And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must ... is no travel expected with this position. As a Utilization Management Nurse Consultant , you...**Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care… more
- CVS Health (Albany, NY)
- …but could be up to 10% in the event of a clinical audit. As a Utilization Nurse Consultant , you will utilize clinical skills to coordinate, document and ... with heart, each and every day. **Position Summary:** This Utilization Management Nurse Consultant (UMNC)...the past 10 years). **Preferred Qualifications:** -2 years of Utilization Review experience -2 years of Managed… more
- CVS Health (Salem, OR)
- …UM ( utilization management) experience within an inpatient/outpatient setting, concurrent review or prior authorization. + 5 years demonstrated ability to make ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- CVS Health (Tallahassee, FL)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including every ... UMNC participating in non-traditional, weekend shift rotation **Preferred Qualifications** + Utilization review experience + Experience with LTAC, skilled rehab,… more
- CVS Health (Carson City, NV)
- …5:00 PM PST with weekends, evenings, and holiday rotations **Preferred Qualifications** - Utilization review experience - Managed Care experience - Bachelor of ... to promote quality effectiveness of Healthcare Services and benefit utilization - Consults and lends expertise to other internal...residence - 3 years of experience as a Registered Nurse - 1 year of clinical experience in acute… more
- CVS Health (Baton Rouge, LA)
- …rotating weekend and holiday schedules. **Preferred** **Qualifications** - Managed care/ utilization review experience preferred Experience in a behavioral ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is knowledgeable in… more
- Defense Health Agency (Oceanside, CA)
- …Provide the communication link between the providers, staff, and civilian sectors regarding utilization review activities. + Review requests for patient care ... **Overview** **Supervisory Nurse ( Consultant )- GS-0610-12 - Camp Pendleton,...+ Optimize continuing education to Medical Treatment Facilities on utilization review issues. + Interface with local,… 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
- Lincoln Financial Group (Columbus, OH)
- …Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like to work here?** At ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization....in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- CVS Health (Tallahassee, FL)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a collaborative… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical ... Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization… 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 ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from… more
- CVS Health (Denver, CO)
- …Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** - Utilization Management review - Managed Care experience - Client processing ... each and every day. **Position Summary** Responsible for the review and evaluation of clinical information and documentation. Reviews...required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… 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 ... RN Program Consultant Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4875514) Apply RN Program ...and site visits to conduct programmatic reviews and training, review staff utilization practices, standards of health… more
- Molina Healthcare (Columbus, OH)
- **Job Description** Looking for a Registered Nurse or Licensed Social worker to support HealthPlans within Molina Healthcare. In this position you will be assisting ... of high speed required. **Job Summary** The Sr. Clinical Performance Consultant is responsible for the successful execution of clinical transformation, performance… more
- Louisiana Department of State Civil Service (Angola, LA)
- …but not limited to: Infection Control, Discharge Planning, Quality Assurance, DRG Coordinator, Utilization Review , and Support Service Review . LEVEL OF WORK: ... but not limited to: Infection Control, Discharge Planning, Quality Assurance, DRG Coordinator, Utilization Review , and Support Service Review . Advises and… more
- Albany Medical Center (Albany, NY)
- …Demonstrates experience in the referral process and use of community resources. 2. Utilization Review a. Reviews data from admission screening to clarify ... changing environment. 8. Basic knowledge of computer systems with skills applicable to utilization review process. Mission, Core Values and Service Excellence 1.… more
- Trinity Health (Mishawaka, IN)
- …for quality care. **JOB SUMMARY:** The inpatient **Certified Wound Ostomy Continency Consultant (CWOCN Consultant ), Registered Nurse ** will provide clinical ... for the patient, unit based resource nurses and the Nurse Manager of each unit. The CWOCN Consultant...as a resource to staff for cost effective, appropriate utilization of wound care dressings, supplies, and pressure reduction… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Nurse Scientist position is responsible for leading the development, coordination, implementation, evaluation, and dissemination of nursing ... plan, and outline priority initiatives based on hospital quality measures. The Nurse Scientist position ensures the highest quality of scholarly and scientific… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Nurse Scientist position is responsible for leading the development, coordination, implementation, evaluation, and dissemination of nursing ... plan, and outline priority initiatives based on hospital quality measures. The Nurse Scientist position ensures the highest quality of scholarly and scientific… more