- Moses/Weitzman Health System (Meriden, CT)
- …licensure as appropriate. Fully established practice standards for productivity and appropriate utilization of care. Position is designed to support evening and or ... health care activities as agreed, eg school based clinic consultant , SNF care. Administrative Maintains board certification/licensure. Attends continuing education… more
- CVS Health (Carson City, NV)
- …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 (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. ... As a Utilization Nurse Consultant , you will utilize clinical skills...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
- CVS Health (Atlanta, GA)
- …do it all with heart, each and every day. **Position Summary** Medicare Predetermination Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
- CVS Health (Phoenix, AZ)
- …the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and Transplant, you'll ... 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 (Woonsocket, RI)
- …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 (Topeka, KS)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central Time zones… more
- CVS Health (Albany, NY)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Management opportunity for RNs with a **New York** state licensure. ... 8:30am - 5pm EST. This role is a registered nurse that utilizes MCG rules and applies medical necessity...unrestricted New York state licensure + 1+ year of Utilization review experience + 1+ year of clinical experience… more
- CVS Health (Springfield, IL)
- …and on the phone collecting and reviewing clinical information from providers. Utilization Management nurses use specific criteria to authorize inpatient ... paced environment NICU experience 3+ years **Preferred Qualifications** Previous Utilization Management experience Spine Experience **Education** Associates… more
- 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
