- Veterans Affairs, Veterans Health Administration (Colorado Springs, CO)
- Summary The Quality Management (QM) Consultant -Regulatory Compliance Registered Nurse (RN) demonstrates leadership, experience, and creative approaches ... to improvement in quality of-care outcomes. The QM Consultant -Regulatory Compliance...organizational level within a facility. Responsible for their assigned quality management program area activities for the… more
- US Tech Solutions (RI)
- …support as required. **Responsibilities:** + Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit ... Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION... review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …service level. The UM Consultant is assigned responsibility for their assigned quality management program area activities for the Medical Center and all ... and proper utilization of resources and care coordination. Responsibilities The Utilization Management (UM) Consultant Registered Nurse (RN) demonstrates… more
- CVS Health (Austin, TX)
- …department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant , you will utilize clinical skills ... Social Worker (LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Nurse Consultant (General) (40 Hour) Hybrid Recruitment # 251202-5927FP-001 Location Hartford, CT Date Opened 12/3/2025 12:00:00 AM Salary $99,806 - ... Improvement Division - is accepting applications for one (1) Nurse Consultant (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5927FP&R1=&R3=) located in Hartford, CT.… more
- CVS Health (Columbus, OH)
- …difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll ... organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high- quality healthcare for members. **Position… more
- CVS Health (Raleigh, NC)
- …and evening hours._ **Must reside in CST or EST zone.** As a Utilization Management Nurse Consultant you will utilizes clinical experience and skills ... And we do it all with heart, each and every day. **Position Summary** _Utilization Management is a 24/7 operation and work schedule will include weekends, holidays… more
- CVS Health (Salem, OR)
- …it all with heart, each and every day. **Position Summary** The **Utilization Management Clinical Nurse Consultant ** utilizes clinical skills to coordinate, ... document, and communicate all aspects of the utilization/benefit management program. **Job duties include (but are not limited to):** + Applies critical thinking and… more
- CVS Health (Lansing, MI)
- …that promote high- quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant , where you'll apply ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- CVS Health (Raleigh, NC)
- …with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization Management ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more