- CVS Health (Lansing, MI)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications: - Must have active, current, and… more
- CVS Health (Trenton, NJ)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit programs, please visit… more
- Albany Medical Center (Albany, NY)
- …Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary ... Range: $31.28 - $51.61 per hour * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of… more
- CVS Health (Frankfort, KY)
- …effectiveness of medical management services. Required Qualifications -1+ years as a registered nurse - Must have active, current, and unrestricted RN license in the ... occasional holiday and weekends depending on business needs Preferred Qualifications - Utilization management experience - Managed care experience - Must be a team… more
- CVS Health (Phoenix, AZ)
- …services both inpatient and outpatient services requiring precertification. + Utilization Management nurses use specific criteria to authorize procedures/services or ... training required 100% participation during 8:30am-5pm Monday-Friday EST. + A Registered Nurse that must hold an unrestricted license in their state of residence,… more
- CVS Health (Frankfort, KY)
- …opportunities to promote quality effectiveness of healthcare services and benefit utilization . + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + There are standard productivity and quality expectations. +… more
- CVS Health (Columbus, OH)
- …in New Albany OH, Chandler AZ or High Point NC. Precertification Nurse Case Manager 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 overall wellness. Services strategies, policies and programs are comprised of network management and clinical coverage policies.What… more
- CVS Health (Columbus, OH)
- …in New Albany OH, Chandler AZ or High Point NC Precertification Nurse Case Manager 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 overall wellness. Services strategies, policies and programs are comprised of network management and clinical coverage policies.What… more
- CVS Health (Austin, TX)
- …Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification. The majority of the time is ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed. Required Qualifications + Must have… more
- CVS Health (Charleston, WV)
- …This role is Telework anywhere! Preference for WV residents or out of state residents that have the WV licensure and compact licensure.Applies critical thinking, ... evidenced based clinical criteria and clinical practice guidelines for services requiring precertification. The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use… more