- Trinity Health FirstChoice (Mishawaka, IN)
- …customers understand their service better, and build relationships.Serves as a consultant , resource person, and role model representing respiratory care in the ... and participate in their resolution.Maintains safe respiratory therapy practices; alerts management of any safety issues or concerns.Performs all duties and… more
- CVS Health (Plantation, FL)
- …Working schedule is Monday-Friday, 8am-5pm (ET). This position reports to the Potential Quality of Care (PQOC) nurse investigator team manager. This position is ... requirements for member and/or provider issues. Fundamental Components + Works Potential Quality of Care cases (Medical and Behavioral Health), along with Patient… more
- US Tech Solutions (May, OK)
- …regulatory and accreditation requirements for member and/or provider issues. Works Potential Quality of Care cases across all lines of business (Commercial and ... support as required. **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit… more
- CVS Health (Columbus, OH)
- …* Serve as an incident reporting expert for Aetna Care Management .* Lead and demonstrate the How We Work Behaviors (specifically collaboration, ... incident reporting* Mentor the care team regarding best practice standards, quality of interventions, problem resolution and critical thinking and standard operating… 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
- CVS Health (Richmond, VA)
- …Qualifications - 3+ years of clinical experience required - 3+ years of Quality experience required - Virginia resident required - Licensed RN with current ... unrestricted state of Virginia licensure required - Must possess reliable transportation and be willing and able to travel approximately 10% of the time. Mileage is reimbursed per our company expense reimbursement policy - 1+ year of experience using Microsoft… more
- CVS Health (Raleigh, NC)
- …of the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- CVS Health (Raleigh, NC)
- …in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- CVS Health (Columbus, OH)
- …deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and ... pm EST. Holiday rotation 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to… more
- CVS Health (Plantation, FL)
- …10:00 AM- 6:30 PM EST No nights, no weekends, and no holidays. The UM Nurse Consultant job duties include (not all encompassing): -Reviews services to assure ... Spanish highly preferred + Compact RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas access to care + Working… more
- CVS Health (Lansing, MI)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and ... employee can live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and ... Eastern Standard Time Holiday rotation 1-2 per year. CCR - Duals UM Nurse ConsultantUtilizes clinical experience and skills in a collaborative process to assess,… more
- PruittHealth (Columbia, SC)
- …and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required systems ... **JOB PURPOSE:** Senior Nurse Consultant serves as a member...achieve and sustain compliance with all applicable regulations and quality outcomes. **KEY RESPONSIBILITIES:** * Annually in collaboration with… more
- CVS Health (Austin, TX)
- …care more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more
- CVS Health (Lansing, MI)
- …No travel is required.Applicants from any state can apply. Prior Authorization UM Nurse Consultant Utilizes clinical experience and skills in a collaborative ... with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and… more
- CVS Health (Columbus, OH)
- …make health care more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA ISNP) ... with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and… more
- NHS Management, LLC (Fayetteville, AR)
- …the successes they experience along the way. We are in search of a qualified Regional Nurse Consultant : The Regional Nurse Consultant will be responsible ... the dissemination of expert advice and oversight to facility management personnel and line staff to ensure that systems...care facilities to ensure that the highest degree of quality care can be provided to the residents at… more
- Truman Medical Centers (Kansas City, MO)
- …(http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Corporate Clinical Nurse Consultant RN-Behavioral Health (8:00am - 4:30pm) ... and Pharmacy. A 547-bed, not-for-profit health system, UH delivers the highest- quality medical care for our patients, with compassion, empathy, and unparalleled… more
- Trinity Health (Mishawaka, IN)
- …in technology, people and capabilities that allow us to set the standard for quality care. **JOB SUMMARY** The inpatient CWOCN Consultant will provide clinical ... and their family members to assist them in the management of their individual wound care needs. Ultimate responsibility...for the patient, unit based resource nurses and the Nurse Manager of each unit. The CWOCN Consultant… more
- ERP International (Anchorage, AK)
- **Overview** ERP International is seeking a **Registered Nurse Lacation Consultant ** for a full-time position supporting the673d Medical Group, Joint Base ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more