- CVS Health (Phoenix, AZ)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime Quality Management Nurse Consultant opportunity within Arizona. ... 60 miles) about 25-50% of the time. The QM Nurse Consultant is a work at home...limited to member services, provider relations and integrated care management ) to achieve the common goal of improving member… 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 (Phoenix, AZ)
- …**Must reside in Arizona, preferably in the Phoenix Metro area.** **Hours: Monday- Friday 8:00am-5:00pm** Responsible for the review and evaluation of clinical ... information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …Duties and responsibilities include but are NOT limited to: Quality Management (QM) Consultant Registered Nurse demonstrates leadership, experience, and ... within a facility. QM Consultant is assigned responsibility for their assigned quality management program area activities for the Medical Center and all… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …and guidance to develop, implement, refine, and maintain a comprehensive quality management /improvement program. Responsibilities The incumbent is responsible ... external agency standards, interpreting VHA handbooks and directives regarding quality management /performance improvement/patient safety issues; collaborating with… more
- CVS Health (Olympia, WA)
- …per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, ... make health care more personal, convenient and affordable. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but… more
- CVS Health (Trenton, NJ)
- …convenient and affordable. **Position Summary** This is a full-time remote Utilization Management Nurse Consultant opportunity. Utilization management ... Work schedules may include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant , you will utilize clinical skills to… more
- CVS Health (Raleigh, NC)
- …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant , you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization/benefit management program. + Utilizes clinical experience and skills in a collaborative process… more
- UNC Health Care (Chapel Hill, NC)
- …select the response below that best describes your experience/education/licensure for the Nurse Consultant position. 2. Licensed to practice as a Registered ... bottom of this page. DepartmentPeds-Children's Research Inst-412019Career AreaHealth Professional (Physician/ Nurse /Other)Is this an internal only recruitment?NoPosting Open Date01/15/2025Application Deadline02/14/2025Position… more
- PruittHealth (Atlanta, GA)
- …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