• Utilization Management Nurse

    CVS Health (Columbus, OH)
    …full-time Utilization Management (UM) Nurse Consultant . As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... reviewing written clinical records. **Key Responsibilities of the UM Nurse Consultant ** (Includes but is not limited...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
    CVS Health (10/25/25)
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  • Utilization Management Clinical…

    CVS Health (Columbus, OH)
    …with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes clinical ... Time_ ). + Previous experience with prior authorization. + Previous experience with utilization management . + Previous experience in an acute care setting. +… more
    CVS Health (10/26/25)
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  • Utilization Management Appeals…

    CVS Health (Columbus, OH)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... Summary** The Appeals Nurse Consultant plays a key role in...by reviewing medical records and applying clinical guidelines for Utilization Management group. This RN must be… more
    CVS Health (10/12/25)
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  • Utilization Management Clinical…

    CVS Health (Columbus, OH)
    …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
    CVS Health (10/26/25)
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  • Wellness Nurse Consultant

    Elevance Health (Cincinnati, OH)
    **Wellness Nurse Consultant ** **Sign on Bonus: $5000** **Field:** This field-based role enables associates to primarily operate in the field, traveling to client ... and together we will drive the future of health care. The **Wellness Nurse Consultant ** position is responsible for developing and recommending customized,… more
    Elevance Health (10/24/25)
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  • Registered Nurse (RN) Quality Specialist…

    Bon Secours Mercy Health (Cincinnati, OH)
    …medical staff and organizational leadership to proactively address quality and /or utilization issues. + Collaborates with hospital departments to ensure site survey ... requirements and conditions of participation. + Serves as an internal consultant and educator for performance improvement activities and patient safety processes.… more
    Bon Secours Mercy Health (10/15/25)
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  • Sepsis Coordinator

    Cleveland Clinic (Garfield Heights, OH)
    …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... when a deviation in standard practice has occurred. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality … more
    Cleveland Clinic (10/16/25)
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  • SQPE Specialist II

    Cleveland Clinic (Cleveland, OH)
    …ensure compliance with standards and improve performance across safety, quality, utilization and experience metrics. This is an exciting opportunity to advance ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality… more
    Cleveland Clinic (10/10/25)
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