Medicare Utilization Management RN Consultant
CVS Health
CVS Health is seeking a Medicare Predetermination Utilization Management Nurse Consultant to assess and coordinate care for members, ensuring appropriate benefits and services. The role requires an RN with 3+ years of experience, active licensure, and Med/Surg background. Flexible weekend shifts follow training, with a comprehensive benefits package and career growth opportunities at CVS Health. #J-18808-Ljbffr CVS Health
- CVS Health in Florida is seeking a Utilization Management Nurse Consultant who will review and coordinate care for members, applying medical necessity criteria... ...and holidays. The position requires an active Florida RN license, 3 years of inpatient nursing experience, and a...SuggestedRemote jobFull timeWeekend workAfternoon shift
$26.01 - $74.78 per hour
...be part of something bigger - helping to simplify health care one person, one family and one community at a time. Utilization Management Registered Nurse (RN) - Remote Make a meaningful impact on patient care from wherever you work. We are seeking an experienced...SuggestedHourly payFull timeTemporary workWork experience placementWork at officeLocal areaRemote workWork from homeAfternoon shift- CVS Health is seeking an experienced Utilization Management RN to support coverage determinations from a remote location in the United States. You will apply clinical criteria across the care continuum and collaborate with providers to improve member outcomes. The role...SuggestedRemote job
$26.01 - $68.55 per hour
...family and one community at a time. Position Summary Medicare Predetermination Utilization Management Nurse Consultant position: Utilizes clinical experience and skills... ...Nurse Must have active current and unrestricted RN licensure in state of residence 1+ years of Med/...SuggestedHourly payFull timeTemporary workWork at officeLocal areaMonday to FridayShift workWeekend work$29.1 - $62.32 per hour
...one family and one community at a time. Position Summary Utilization Management Nurse Consultant - must reside in Florida. Work from home anywhere in... ...Required Qualifications Active, unrestricted Registered Nurse (RN) license in the state of Florida. Minimum of 3 years of...SuggestedHourly payFull timeTemporary workWork experience placementLocal areaWork from homeAfternoon shift$29.1 - $62.32 per hour
...bigger - helping to simplify health care one person, one family and one community at a time. Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) 100% Remote | Florida Residents Only | Monday-Friday, 8:00 AM-5:00 PM EST Are you a Licensed Behavior...Hourly payFull timeTemporary workWork at officeLocal areaRemote workMonday to FridayAfternoon shift$75k - $100k
...Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures... ...claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty...For contractorsWork at officeLocal areaImmediate startRemote work- CLINICAL REVIEWER RN job at Integrated Home Care Services, Inc.. Hollywood, FL. Job... ...services. IHCS has a select network of Medicare and/or Medicaid Certified and... ...training program What Will You Be Doing As a Utilization Management Nurse, you will ensure that home health...Full timeTemporary work
- American Traveler is hiring an RN Case Manager for a Case Management department requiring at least 2 years of recent case management experience... ...Minimum 2 years of recent experience in case management/utilization review required No employment gaps of 90 days or more...Daily paidLocal areaDay shift
- ...coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective... ...payer experience. Qualifications Active Registered Nurse (RN) license with 3+ years of experience in utilization review or...
- American Traveler, LLC. is hiring an RN Case Manager for a hospital-based case management team in Florida. The role requires active FL or... ..., and at least two years of recent case management or utilization review experience. The position follows a daytime schedule,...
$2,111 per week
...Travel RN - Case Management/Utilization Review - Case Management American Traveler Tallahassee, Florida, United States Position ID: P-762916 Position status: Open Assignment type: travel Shift: Days Length (weeks): 13 Openings: 1 Start date: 20...Weekly payShift workDay shift- ...one of our Professional Recruiting Consultants today to see how a conversation can... ...member care • Educate providers on utilization and medical management processes • Provide clinical knowledge... ...needed Qualifications Qualifications: -RN, BSN preferred. -2+ years of...Private practiceShift work
$75k - $100k
WPS—A health solutions company is seeking a Registered Nurse for Utilization Management to evaluate medical necessity and appropriateness of services. The role may cross-train into Case Management and grow into a combined UM/CM position with potential future advancement...Remote job- Integrated Home Care Services (IHCS) seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency... ...to optimize patient outcomes. State licensure as an LPN or RN and a minimum of 2 years in Utilization Management are...Remote job
- Centers Plan for Healthy Living in New York is hiring a Full Time Registered Nurse, entry level welcome, to join the utilization management team. You will assess and process authorization requests to determine medical necessity and ensure needed care services and member...Full time
- ...and Experience: • Current FL RN licensure • Registered Nurse... ...ER, ICU) • Experience with Utilization Review and/or Prior Authorization... ...benefit policy and medical management guidelines to authorize... ...referrals for specialty physician consultation with non-participating...
$40 - $45 per hour
...United States without sponsorship* We are looking for a Project Management Consultant-Level 1 on behalf of our client. This is a 1-year contract... ...such as Microsoft Project and Smartsheet. Familiarity with utility, construction, renewable energy, or NERC compliance projects...Contract workFor contractors$1,748 per week
...Registered Nurse (RN) | Intermediate Care Location: Tallahassee, FL Agency: Magnet... ...level care. You will assess, monitor, and manage patients' conditions, collaborating with... .... Critical Thinking and Decision Making: Utilize clinical judgment and critical thinking...Full timeContract workImmediate startShift workNight shift- ...rating from the Centers for Medicare & Medicaid Services (CMS). Education... .../ Qualifications Current RN licensure in the state of... ..., and modifying patient care utilizing evidence based practices. The... ...care and outcomes. In managing patient care the RN will take...Daily paid
$1,748 per week
...Registered Nurse (RN) | Intermediate Care Location: Tallahassee, FL Agency: Magnet... ...level care. You will assess, monitor, and manage patients' conditions, collaborating with... .... Critical Thinking and Decision Making: Utilize clinical judgment and critical thinking...Full timeContract workImmediate startFlexible hoursShift workNight shift- ...rating from the Centers for Medicare & Medicaid Services (CMS). Education... ...Clear and Active RN licensure in the State of Florida... ..., and modifying patient care utilizing evidence based practices. The... ...patient care and outcomes. In managing patient care the RN will take...Night shift
- ...ID:98085Florida Power & Light Company is the largest electric utility in the U.S., providing reliable energy to nearly 12 million Floridians... ...application of advanced engineering, economic, and project‑management principles to optimize project scope, risk allocation, and...Contract workFor contractorsLocal areaRelocation
- ...Restoration Business Development Manager Coral Springs, United States | Posted on 06/08/2023 Job Description As a leading provider of... ...sales cycle within the restoration industry. Responsibilities Utilize your existing client list and network in South Florida to develop...
- AC Disaster Consulting is seeking a seasoned Emergency Management Consultant to support corporate operations, client engagements, and project work remotely with travel up to 50%. The role emphasizes advisory services for government and private sector clients, plan improvements...Remote job
- ...products, to commercial real estate development, to property management and logistics. DIVISION OVERVIEW With hundreds of Distributor... ...opportunities, conversion targets, supply solutions, and program utilization gaps across the Kelly’s distribution network. Partners with...Work at officeShift work
$65k - $70k
Emergency Management Consultant, Recovery (Environment & Historic Preservation) Emergency Management Consultant, Recovery (Environment & Historic Preservation) 1 day ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. AC Disaster...Full timeContract workTemporary workPart timeWork experience placementSeasonal workWork at officeLocal areaRemote workVisa sponsorshipFlexible hoursWeekend workAfternoon shift- ...consistently meeting sales targets through consultative, B2B selling. This role sells training,... ...case for the proposed solution. Manage opportunities through the full lifecycle... ...professionals to drive sales. Sales Metrics Utilize Salesforce CRM as the system of record for...Contract work
- ...alternative application process. Senior Manager, Business Development Salary Full-Time... ...stakeholders worldwide. This role combines consultative sales, executive relationship... ...robust pipeline and expand awareness and utilization of The IIA's Quality Services offerings...Full timeFor contractorsWork at officeLocal areaWorldwide
- ...development, legislative and amendment processes. Experience utilizing Florida's budgeting systems (LAS/PBS and SAPS). Experience with... ...Florida Fiscal Portal. Assists the Regulatory Program Budget Manager and other staff with budgetary needs. Performs other related duties...Work at officeMonday to Friday
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