- CVS Health (Richmond, VA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Richmond, VA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
- CVS Health (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management (UM) Nurse Consultant is a remote, full-time role ... external stakeholders. The position also involves coaching healthcare staff on utilization management principles and contributing to policy development.… more
- CVS Health (Richmond, VA)
- …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... Qualifications** + Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or Nursing Diploma… more
- CVS Health (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence * Utilization Management is a 24/7 operation and… more
- CVS Health (Richmond, VA)
- …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 EST zone. **Education**… more
- CVS Health (Richmond, VA)
- …3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
- CVS Health (Richmond, VA)
- …Virginia licensure and/or compact licensure. Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize… more
- CVS Health (Richmond, VA)
- …the VA licensure and compact licensure. Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize… more
- Prime Therapeutics (Richmond, VA)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more