- CVS Health (Olympia, WA)
- …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 (Annapolis, MD)
- …Bachelor's degree preferred/specialized training/relevant professional qualification. Registered Nurse (RN) required. **Prior Relevant Work Experience** 3-5 ... years Essential Qualifications Working knowledge of problem solving and decision making skills. Working knowledge of medical terminology. Working knowledge of digital literacy skills. Ability to deal tactfully with customers and community. Ability to handle… more
- CVS Health (Phoenix, AZ)
- …that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse Consultant to join our remote team. **Key ... of a computer. + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM specialty teams as needed, ensuring continuity… more
- CVS Health (Richmond, VA)
- …a team environment. Through the use of clinical tools and information/data review, the UM Nurse Consultant reviews services to assure medical necessity, ... all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a Utilization Nurse … more
- CVS Health (Phoenix, AZ)
- …in the lives of patients facing complex medical journeys. As a Utilization Management ( UM ) Nurse Consultant specializing in Oncology and Transplant, you'll ... + Minimum of 1 year of experience in Oncology and Transplant either in UM , concurrent review, or prior authorization + 3+ years of experience in Acute clinical… 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
- CVS Health (Phoenix, AZ)
- …heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated **Appeals Nurse Consultant ** to join our remote team. In this role, you will ... with internal/external clinician support as required. + This position may support UM (includes expedited), MPO, Coding, or Behavioral Health appeals. + This is… 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
- ERP International (Yuma, AZ)
- **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position at the Camp Pendleton **Branch Health Clinic** in ... and databases for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with social work case management. *… more
- University of Miami (Miami, FL)
- …a system that elevates any abnormal results (non - critical values) to the nurse who in turn will contact the physician accordingly 5. Ens ures that patients ... patient/family teaching using available resources and tools. 12. Acts as consultant to clinical staff in assisting with unfamiliar procedures/treatments. 13.… more