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UTILIZATION MANAGEMENT NURSE CONSULTANT

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

CompanyCvs Health
AddressHarrisburg, PA
CategoryAccounting/Finance
Salary$29.10 - $62.31 an hour
Job typeFull-time
Date Posted 6 days ago See detail

Utilization Management Nurse Consultant

Cvs Health

Harrisburg, PA

$29.10 - $62.31 an hour

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

Telephonic Nurse Case Manager II New

Elevance Health

ATLANTA, GA

Ensures member access to services appropriate to their health needs. . Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. . Imple...

Telephonic Nurse Case Manager I New

Elevance Health

ATLANTA, GA

Ensures member access to services appropriate to their health needs. . Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. . Imple...

Nurse Medical Management II New

Elevance Health

Atlanta, GA

Conducts precertification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, be...

Quality Management Nurse I

University Health

San Antonio, TX

POSITION SUMMARY/RESPONSIBILITIESCoordinates and collaborates with Community First Health Plans, Inc. (Community First), various departments to ensure that contractual, regulatory, and accreditation requirements, including Nationa...

Clinical Manager Nursing Practice

Hca Healthcare

Nashville, TN

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transporta...

registered nurse - Whiteville, United States - Liberty Healthcare Management

Liberty Healthcare Management

United States

Assure quality nursing care for patient by following physician's orders, state and federal regulations and this Facility's policies and procedures. Administers all medications (oral, s.q., I.M., or I.V.) as ordered by M.D. and acc...

Registered Nurse – Case Management- Case Manager - Travel - (CM RN)

American Mobile Healthcare

Seattle, WA

$2,237.01/week

Join this highly motivated team of caregivers and enjoy a challenging and welcoming environment based on optimal patient care. Relax at a sidewalk caf and enjoy a latt, stroll along a waterfront park at sunset, go kayaking on La...

Nurse Manager - Periop Medicine, Procedural Sedation - Sacramento

Kaiser Permanente

Sacramento, CA

Manages the operations of 24-hour departments that may be at multiple locations. Ensures Assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal,...

Assistant Nurse Manager - Emergency Department - Nights

Kaiser Permanente

San Francisco, CA

Manages the units day to day clinical operations including practice standards, staffing, payroll, budgets, fiscal management, and quality improvement. Ensures the highest quality of care is provided and is in compliance with feder...

RN - Assistant Nurse Manager (Mental Health)

Department Of Veterans Affairs

Palo Alto, CA

Competitive

Successfully meets the critical and non-critical elements of the Executive Career Field (ECF) performance Plan. Provides Information Security including protection of printed and electronic files containing sensitive data in accord...

Assistant Nurse Manager-ICU

Kaiser Permanente

Walnut Creek, CA

Manages the units day to day clinical operations including practice standards, staffing, payroll, budgets, fiscal management, and quality improvement. Ensures the highest quality of care is provided and is in compliance with feder...

Pain Management Nurse Practitioner opening in northern NH

Britt Medical Search

Berlin, NH

Provides office-based Pain Management services to new and established patients (adults), including medication management, certification for medical cannabis, education/counseling, monitoring of medication compliance via PDPM and u...

Manager Nursing PACU/AOD Main/PAT

Houston Methodist

Houston, TX

Provide personalized care and service by consistently demonstrating our I CARE values:INTEGRITY: We are honest and ethical in all we say and do.COMPASSION: We embrace the whole person including emotional, ethical, physical, and sp...

Utilization Management Nurse Consultant

Cvs Health

Hartford, CT

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

Interventional Pain Management Nursing Assistant

Department Of Veterans Affairs

Lorida, FL

Competitive

You must be a U.S. Citizen to apply for this job. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who...

Manager Nursing - Emergency Department

Nurserecruiter.com

Seattle, WA

$205,379/week

As Manager Nursing, you will oversee the operations of the Emergency Department, ensuring adherence to company policies, procedures, and regulatory guidelines. Your responsibilities include meeting financial targets, maintaining p...

Utilization Management Nurse Consultant

Cvs Health

Springfield, IL

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

*Quality Management Nurse Consultant

Adecco

Woonsocket, RI

$ 36.2 - $ 39.11 / Hour

Reviews documentation and evaluates the necessity of provider requests, but applying national and state based criterion, thus conducting Medical Necessity Review.. Staff may be required to contact the providers of record, vendor...

Utilization Management Nurse - Dallas, TX

Adecco

Dallas, TX

$ 80000 - $ 90000 / Year

Five years inpatient clinical nursing experience in an acute care hospital setting required.. Minimum of two years Utilization Management acute care setting experience required. . Minimum of one-year drafting and submitting reco...

Assistant Nurse Manager-ICU

Kaiser Permanente

Vacaville, CA

Manages the units day to day clinical operations including practice standards, staffing, payroll, budgets, fiscal management, and quality improvement. Ensures the highest quality of care is provided and is in compliance with fede...

Registered Nurse Manager - Medical Intensive Care Unit MICU

Ascension

Texas, United States

Department: Medical Intensive Care Unit (MICU). Schedule:40 hrs/week, Mon-Fri. Hospital:Ascension Seton Medical Center Austin. Location:1201 West 38th Street, Austin TX 78705. Ensure compliance with regulatory and accreditation...

Utilization Management Nurse Consultant

Cvs Health

Columbus, OH

Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. We are health care innovators.Fundamentals:Through the use of cli...

Nurse Case Manager

Sstar

Fall River, MA

$61.5K - $77.9K a year

403B Dental insurance Disability insurance through Massachusetts PFML Employee discounts, cell phone, eyewear etc. Health insurance Life insurance Paid time off Vision insurance Flexible Spending Account Opportunities to earn CEU'...

registered nurse - Yadkinville, United States - Liberty Healthcare Management

Liberty Healthcare Management

United States

Assure quality nursing care for patient by following physician's orders, state and federal regulations and this Facility's policies and procedures. Administers all medications (oral, s.q., I.M., or I.V.) as ordered by M.D. and acc...

Clinical RN Educator 1, Nursing Practice Management, FT, 8A-4:30P

Baptist Health South Florida

Miami, FL

At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in...

Registered Nurse – Case Management- Case Manager - Travel - (CM RN)

American Mobile Healthcare

Houston, TX

$1,739.71/week

Join this highly motivated team of caregivers and enjoy a challenging and welcoming environment based on optimal patient care. BLS Preferred QualificationsMeditech FACILITY LOCATIONFrom rodeos and performing arts to space explorat...

Case Management - Registered Nurse

Trusted Health

Seattle, WA

$2500 per week

Skills Checklist: Yes. References: Yes. License Type: registered. License State: WA. Certifications: Basic Life Support. Job Type: Travel. Nurse/Patient: . Shift Type: Day. Contract Date: 2024-06-17. Expected Length: 13 weeks....

Nursing Education Nurse Manager

Department Of Veterans Affairs

Loma Linda, CA

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

Full Time Hospice Nurse Case Manager

Sunset Hospice

Middleboro, MA

$45 - $52 an hour

Completes an initial, comprehensive, and ongoing comprehensive assessment of patient and family to determine hospice needs. Provides a complete physical assessment and history of current and previous illness(es). Provides professi...