- CVS Health (Raleigh, NC)
- …is part of the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant , you will utilize clinical skills ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live… more
- CVS Health (Columbus, OH)
- … Consultant 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...times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all… more
- CVS Health (Harrisburg, PA)
- …can live in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and employee… more
- CVS Health (Austin, TX)
- …to make health care more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes ... Qualifications + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...(twice per month) Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee ... 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 ... to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical experience and...RN License or license in multiple states + UM Nurse Consultant experience + Experience with overseas… more
- CVS Health (Columbus, OH)
- …is a work at home position and employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills to coordinate, document and ... communicate all aspects of the utilization /benefit management program. You would be responsible...and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical… 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) ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+ years of… more
- CVS Health (Trenton, NJ)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. - Gathers clinical information and applies… more
- CVS Health (Columbus, OH)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Qualifications - 3+ years of experience as a Registered Nurse - Must possess 1+ years of clinical experience… more
- CVS Health (Columbus, OH)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...Required Qualifications- 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
- CVS Health (Jefferson City, MO)
- …and external constituents in the coordination and administration of the utilization /benefit management function.- Typical office working environment with ... weekend position Required Qualifications - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in state of… more
- CVS Health (Trenton, NJ)
- …work occasional holiday and weekends depending on business needs Preferred Qualifications - Utilization management experience - Managed care experience - Must be ... services. Maintains accurate and complete documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally… more
- CVS Health (Phoenix, AZ)
- …and services both inpatient and outpatient services requiring precertification. + Utilization Management nurses use specific criteria to authorize ... training required 100% participation during 8:30am-5pm Monday-Friday EST. + A Registered Nurse that must hold an unrestricted license in their state of residence,… more
- CVS Health (Phoenix, AZ)
- …talking, listening and computer useRequired Qualifications + 1+ year varied Utilization Management experience within an inpatient/Outpatient setting, concurrent ... 3 weeks training with 100% participation during 8:30am-5pm Monday-Friday. + A Registered Nurse that must hold an unrestricted license in their state of residence,… more
- CVS Health (Austin, TX)
- …products, services and/or programs + Identifies opportunities to promote benefit utilization + Typical office working environment with productivity and quality ... and written Required Qualifications + 3+ years of acute experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of… more
- CVS Health (Columbus, OH)
- …in New Albany OH, Chandler AZ or High Point NC Precertification Nurse Case Manager is responsible for telephonically assessing, planning, implementing and ... coordinating all case management activities with members to evaluate the medical needs...Services strategies, policies and programs are comprised of network management and clinical coverage policies.What is A1A?Aetna One Advocate… more
- CVS Health (Charleston, WV)
- …This role is Telework anywhere! Preference for WV residents or out of state residents that have the WV licensure and compact licensure.Applies critical thinking, ... evidenced based clinical criteria and clinical practice guidelines for services requiring precertification. The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use… more
- CVS Health (Phoenix, AZ)
- …the state of Arizona or Compact RN licensure Preferred Qualifications: + Utilization management experience preferred. + Acute care setting experience preferred ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in… more
- Immigration and Customs Enforcement (IN)
- … Review Consultant will report directly to the IHSC Regional Utilization Manager with the Utilization Management Program Administrator. This ... DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and subject matter expert...cases for high level of review and participates in Utilization Management Review Committee activities as needed.… more