- CVS Health (Atlanta, GA)
- …that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key ... 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 (Atlanta, GA)
- …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… more
- CVS Health (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zone. **Education**… more
- CVS Health (Atlanta, GA)
- …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
- CVS Health (Atlanta, GA)
- …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
- CenterWell (Savannah, GA)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... early detection. The PL is responsible for executing the clinical strategy through the management of their own patient panel as well as those of the clinicians whom… more
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