- CVS Health (Indianapolis, IN)
- …and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active current and ... unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours **Preferred Qualifications** - 2+ years of clinical experience required in med surg or specialty… more
- CVS Health (Austin, TX)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... (LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management ( UM ) Nurse Consultant role is 100% remote and the candidate… more
- CVS Health (Austin, TX)
- …and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing): ... it all with heart, each and every day. **Position Summary** This Utilization Management ( UM ) Nurse Consultant role is 100% remote and the candidate can live… more
- CVS Health (Baton Rouge, LA)
- …with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts high-acuity, timely, ... determinants and unique member needs. * Maintain accurate, timely documentation in UM systems, ensuring data integrity and compliance. * Participate in quality… more
- CVS Health (Phoenix, AZ)
- …healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team. In this role, you'll ... + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM specialty teams as needed, ensuring continuity of care and… more
- US Tech Solutions (RI)
- …+ MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + RN with current unrestricted state licensure **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide… more
- University of Michigan (Ann Arbor, MI)
- CLINICAL CARE COORDINATOR- Lactation Consultant (Von Voigtlander Womens Hospital (VVWH) Apply Now **Job Summary** The Lactation Consultant will provide expert ... staffed by a diverse group of professionals, including Certified Nurse Midwives, Obstetricians, Family Practice Physicians, Maternal-Fetal Medicine Specialists,… more
- Waystar (Atlanta, GA)
- **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer Success Organization who will provide clinical insight ... delivery of the product, interacting with customer end users and managers. The Consultant will be responsible for ensuring that the complexity of our AI technology… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …healthcare? Bring your true colors to blue. The RoleThe Clinical Business Consultant for Cost and Trend Management is responsible for identification, outreach and ... as strong health care industry knowledge. The Clinical Business Consultant works with a wide variety of stake holders...levels of the organization. Education and Experience: + Registered nurse with BSN and 3-5 years in a managed… more
- Truman Medical Centers (Kansas City, MO)
- …Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse ( UM RN) collaborates with members of the healthcare team to ... care through monitoring of healthcare resources for effective and efficient utilization. The UM RN serves as internal consultant to healthcare team members by… more
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