- CVS Health (Hartford, CT)
- …that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse Consultant to join our remote team. **Key ... of a computer. + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM specialty teams as needed, ensuring continuity… more
- CVS Health (Tallahassee, FL)
- …a 24/7 operation and work schedule may include weekends, holidays, and evening hours._ ** UM Nurse Consultant ** Fully Remote- WFH **Position Summary** + ... Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. + Gathers clinical information and applies the… more
- CVS Health (Richmond, VA)
- …do it all with heart, each and every day. **Position Summary** The Utilization Management ( UM ) Nurse Consultant is a remote, full-time role responsible for ... evaluating the medical necessity and appropriateness of healthcare services using evidence-based clinical criteria. This position involves conducting utilization reviews, collaborating with healthcare providers, and supporting care coordination to ensure… more
- CVS Health (Madison, WI)
- …extended periods 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 medical necessity criteria for appropriate utilization of services. + Utilizes clinical… more
- CVS Health (Baton Rouge, LA)
- …distractions from work._ **Required Qualifications** + 1 year of varied UM (utilization management) experience within an **outpatient** setting, concurrent review or ... ability to make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their state of residence,… more
- CVS Health (Hartford, CT)
- …with internal/external clinician support as required. This position may support UM (includes expedited), MPO, Coding, or Behavioral Health appeals. **Required ... Qualifications** + Must have active and unrestricted RN licensure in state of residence + 3+ years clinical experience **Preferred Qualifications** + Appeals Experience + Managed Care Experience + Utilization review experience + Proficiency with computer… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + RN with current unrestricted state licensure **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide… more
- CVS Health (Phoenix, AZ)
- …Counselor (LPC) + Licensed Marriage and Family Therapist (LMFT) + Registered Nurse (RN) + Associate-level licenses may be considered based on relevant experience. ... + Knowledge of Behavioral Health Outpatient Services. + Utilization Management ( UM ) Experience. **Education** + Master's degree required for behavioral health… more
- University of Miami (Miami, FL)
- …this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . JOB DESCRIPTION UM Title: Senior Registered Nurse Supervisor's ... 2014. Job Summary (Purpose and Function): The Pain Management Nurse will be a professional registered nurse ...and variances to the plan of care. Documents in UM Care program intra-procedure assessment of patient condition. Planning… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE (Ambulatory Care Services; Ambulatory Care Adult Heart Transplant Clinic) Apply Now **Mission Statement** Michigan Medicine improves the health of ... Night Shift Weekend Differential- $6.90 / hour + Charge Nurse Differential- $1.00 / hour What Benefits can you...identify and support educational needs. + Serve as a consultant to nursing personnel and other health care professionals… more