- University of New Mexico - Hospitals (Corrales, NM)
- …promote and facilitate communication, problem solving, decision-making, crisis intervention, resource utilization , and conflict management * PATIENT SAFETY - ... delivery of optimal and safe patient care which includes fiscal management , standards compliance, clinical practice, staff development, oversight and active… more
- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... health care activities as agreed, eg school based clinic consultant , SNF care. Administrative Maintains board certification/licensure. Attends continuing education… more
- CVS Health (Austin, TX)
- …of the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant , you will utilize ... preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can… more
- CVS Health (Austin, TX)
- …of the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant , you will utilize ... all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review ... improvement, policy review, and education related to NICU and special populations utilization management . * Serve as a clinical resource on NICU care for… more
- CVS Health (Austin, TX)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in MST/PST zones… more
- CVS Health (Austin, TX)
- …more compassionate. And we do it all with heart, each and every day. Utilization Management - Infertility Precertification unit **Position Summary** This is a ... 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 (Phoenix, AZ)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring… more
- CVS Health (Harrisburg, PA)
- …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical ... best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of… more
- CVS Health (Frankfort, KY)
- …with heart, each and every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant . **Must reside in the state of Kentucky or ... and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate,… more
- Truman Medical Centers (Kansas City, MO)
- …time **Work Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse (UM RN) collaborates with members of the ... solving, and proficient organization and planning skills Preferred Qualifications: + Utilization Management experience + Experience with managed care,… 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
- Actalent (Des Moines, IA)
- …HEDIS Nurse ConsultantJob Description We are seeking a dedicated HEDIS Nurse Consultant to support our annual Healthcare Effectiveness Data and Information ... abstraction and familiarity with HEDIS measure specifications. + Experience in utilization management , quality management /review, accreditation, or… more
- CVS Health (Columbus, OH)
- …heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant ** to join our remote team. In this role, you will be ... clinical experience. **Preferred Qualifications** + Appeals, Managed Care, or Utilization Review experience. + Pre Certification or Pre Authorization experience… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …concerns Key Qualifications + Strong clinical skills and understanding of HMM's Utilization Management , Case Management and operational procedures, Medical ... your true colors to blue. The RoleThe Clinical Business Consultant for Cost and Trend Management is...concerns that may require additional attention. + Partner with Utilization and Care Management to provide clinical… more
- Carle Health (Normal, IL)
- …Lactation Consultants (IBCLC) within 2 years - International Board of Lactation Consultant Examiners (IBCLE); Licensed Registered Professional Nurse (RN) - ... Overview The staff Registered Nurse (RN) is a professional caregiver who assumes...frame and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Lactation Support Consultant position functions at the Proficient level according to Benner's model of clinical practice and is responsible ... breast feeding support under the general supervision of the Nurse Director. In addition to functioning as a staff... Director, Managers and Charge Nurses, the Lactation Support Consultant position is responsible for the quality of patient… more
- CVS Health (Austin, TX)
- …for continuous learning and passion to improve population health. Clinical Program Consultant (CPC) plays a key role in delivering strategic clinical insights to ... As a CPC, you will collaborate closely with account teams, care management , Regional Analytic Consulting, and key enterprise partners to support customer objectives.… more
- Carle Health (Urbana, IL)
- …for a designated timeframe and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial, and human resources ... Heart Association (AHA)American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation… more
