- CVS Health (Albany, NY)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area + Managed Care experience preferred, especially Utilization Management + Preference for those residing in EST zones **Education** +… more
- CVS Health (Raleigh, NC)
- …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
- CVS Health (Tallahassee, FL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days...their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3+ years of… more
- CVS Health (Frankfort, KY)
- …and every day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a work from home anywhere in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate,… more
- CVS Health (Baton Rouge, LA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** - Licensed… more
- PruittHealth (Columbia, SC)
- **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
- 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
- Lincoln Financial (Tallahassee, FL)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- CVS Health (Raleigh, NC)
- …9:00 PM EST approximately quarterly **Job Descriptions** The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and ... Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits… more
- CVS Health (Hartford, CT)
- …Health appeals. Required Qualifications * Must have active and unrestricted Registered Nurse (RN) licensure in state of residence * 3+ years clinical experience ... Preferred Qualifications * Appeals Experience * Managed Care Experience * Utilization review experience * Proficiency with computer skills including navigating… more
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