- Adecco US, Inc. (Woonsocket, RI)
- Adecco is currently assisting a local client, recruiting for Quality Management Registered Nurse Consultant working from home. For instant consideration, ... Apply Now! Requires an RN with unrestricted active license 3 years of clinical experience required- Managed Care/Medicare experience required.( This experience is not negotiable ) Schedule: M-F 8-5 Responsible for the review and evaluation of clinical… more
- Veterans Affairs, Veterans Health Administration (White City, OR)
- Summary The Quality Management (QM) Consultant Registered Nurse (RN) primary responsibilities include leadership and management for planning, ... Crest Trail that's open to mountain bikers. The Quality Management (QM) Consultant Registered Nurse (RN) is responsible for developing and implementing… more
- CVS Health (Scottsdale, AZ)
- …Components/Expectations* Serve as an incident reporting expert for Aetna Care Management .* Lead and demonstrate the How We Work Behaviors (specifically ... incident reporting* Mentor the care team regarding best practice standards, quality of interventions, problem resolution and critical thinking and standard operating… 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 (Columbus, OH)
- …role is fully remote and employee can live in any state. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... document and communicate all aspects of the utilization/benefit management program. You would be responsible for ensuring the...times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all… more
- CVS Health (Harrisburg, PA)
- …in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... to make health care more personal, convenient and affordable. Position Summary: 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 (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
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Nurse Consultant (Children and Families) (40 Hour) Recruitment # 240424-5928FP-001 Location Middletown, CT Date Opened 5/1/2024 12:00:00 AM Salary $97,371 - ... Solnit Children's Hospital South Campus in Connecticut as a Nurse Consultant (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5928FP&R1=&R3=) . In this role,… 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
- 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
- CVS Health (Phoenix, AZ)
- …on Arizona time zone. No weekends, holidays are required. The UM Clinical Consultant utilizes clinical skills to coordinate, document and communicate all aspects of ... the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care, and medical necessity… more
- Brockton Hospital (Brockton, MA)
- …with the appropriate management of their lactation needs. + Acts as consultant , educator, and participative role model to medical and nursing staff involved in ... and augment teaching provided by nursing staff. + Evaluates the lactation management program/services through quality improvement studies. + Orients new… more
- CVS Health (Springfield, IL)
- …engagement and promote increased access to health care and services and to close quality and health equity gaps. The QM Consultant drives value through driving ... care more personal, convenient and affordable. Position Summary The QM Consultant has a key role in developing and implementing data-driven strategies/interventions… more
- CVS Health (Columbus, OH)
- …the US Work hours: 8:30am-5:00pm EST, Monday-Friday. This position is for a UM nurse consultant who will be joining our reconsideration team. A reconsideration ... nurse will review any additional information submitted within the...coordinate, document and communicate all aspects of the utilization/benefit management program. Utilizes clinical experience and skills in a… more
- CVS Health (Trenton, NJ)
- …auditing of approval, extensions, and denial letters. Promotes and supports quality effectiveness of the healthcare services. Maintains accurate and complete ... documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally... services. Required Qualifications -1+ years as a registered nurse - Must have active, current, and unrestricted RN… more
- CVS Health (Columbus, OH)
- …other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and ... constituents in the coordination and administration of the utilization/benefit management function. + Typical office working environment with productivity and… more