• Utilization Management

    CVS Health (Frankfort, KY)
    …- SEE REQUIRED QUALIFICATIONS FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
    CVS Health (07/25/25)
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  • Utilization Management

    CVS Health (Frankfort, KY)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (07/31/25)
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  • Utilization Management Nurse…

    CVS Health (Frankfort, KY)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse…

    CVS Health (Frankfort, KY)
    clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...that support cost-effective quality care for members. Work in clinical telephone queue for 3 to 4 hours a… more
    CVS Health (07/30/25)
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  • Utilization Management Nurse…

    CVS Health (Frankfort, KY)
    …3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
    CVS Health (07/26/25)
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  • Utilization Management Nurse…

    CVS Health (Frankfort, KY)
    …- active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active ... shift premium. Occasional Overtime may be required. **Position Summary** Utilizes clinical experience and skills in a collaborative process to implement, coordinate,… more
    CVS Health (07/31/25)
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  • Pharmacy Network Management

    Prime Therapeutics (Frankfort, KY)
    …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more
    Prime Therapeutics (07/15/25)
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  • Sr. Consultant , Territory…

    Cardinal Health (Frankfort, KY)
    **_What Specialty Networks contributes to Cardinal Health_** Specialty Networks creates clinical & economic value for independent specialty providers & partners in ... Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be...Member Profiles and overall success of membership network with utilization and optimization of Salesforce keeping up to date… more
    Cardinal Health (07/25/25)
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  • Workfront Configuration Consultant

    Eliassen Group (Frankfort, KY)
    … to support the implementation of Workfront as an Enterprise Portfolio and Project Management tool. As the Senior Consultant , you will work closely with our ... **Workfront Configuration Consultant ** **Anywhere** **Type:** Contract **Category:** Development **Industry:** Insurance **Workplace Type:** Remote **Reference ID:**… more
    Eliassen Group (07/01/25)
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  • QM Nurse Consultant

    CVS Health (Frankfort, KY)
    …Friday 8:00am - 5:00pm in time zone of residence_** **Preferred Qualifications** - Utilization Management review - Managed Care experience - Client processing ... day. **Position Summary** Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained… more
    CVS Health (07/31/25)
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