- CVS Health (Dover, DE)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- CVS Health (Dover, DE)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Dover, DE)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
- CVS Health (Dover, DE)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a… more
- CVS Health (Dover, DE)
- …procedures/services or initiate a Medical Director referral as needed. Assists management with training new nurse reviewers/business partners or vendors ... meet quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3+ Years of...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CenterWell (Dover, DE)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- CenterWell (Dover, DE)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
- CVS Health (Dover, DE)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Sharecare (Dover, DE)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Veterans Affairs, Veterans Health Administration (Wilmington, DE)
- …the Wilmington VAMC for Home Based Primary Care (HBPC) Outpatient. Responsibilities The Nurse Home Based Primary Care (HBPC) Outpatient Staff Registered Nurse ... of licensed vocational nurses/nursing assistants, as appropriate to the setting. This nurse provides direct Veteran care and care coordination, as it pertains, to… more
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