- CVS Health (Columbus, OH)
- …lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital ... skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and… more
- Actalent (Bakersfield, CA)
- Remote Concurrent Review Nurse Job...projects within utilization management as part of the clinical review team + Partners and works with Medical ... Description We are seeking a dedicated Concurrent Review Nurse to perform concurrent reviews, assess...perform concurrent reviews, assess members' overall health, evaluate the medical necessity of care, and contribute to discharge planning… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 ... and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to...evaluate the type of care being delivered, and determine medical necessity. This role also involves contributing to discharge… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse ** to work from our ... quickly and completely, provide status updates to ensure customer satisfaction. + Review assigned medical bills, apply technical insights, applying discretion… more
- Medical Mutual of Ohio (OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Clinical Appeal & Claim Review Nurse II_ **Location:** _Ohio_ **Requisition ID:** _2500127_ ... stay and level of care. + Extrapolates and summarizes medical information for physician review or other...degree preferred. + 3 years experience as a Registered Nurse in acute care, critical care, emergency medical… more
- CVS Health (Lansing, MI)
- …EST Hours; Shift times may vary based on business needs) **Location** : 100% Remote (US only) **Position Summary** American Health Holding, Inc. (AHH), a division of ... Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible,...members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant - Oncology and Transplant to join our… more
- CVS Health (Phoenix, AZ)
- …a team that's making a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in ... in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position… more
- CVS Health (Salt Lake City, UT)
- …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** **Shift schedule is ... of residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS...**Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in… more
- aptihealth (Clifton Park, NY)
- …and coordinate patient care as required/requested by member's prescriber + Perform patient medical review and gather additional medical history information ... aptihealth is a digital technology platform with an affiliated medical group that makes it easier for people to...in being diverse and inclusive The Role The Registered Nurse Case Manager team at AptiHealth is pivotal to… more
- CVS Health (Salt Lake City, UT)
- …skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and ... Occasional Overtime may be required. This position will be remote working from home anywhere in the US. **Position...Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. +… more