Utilization Management Nurse Consultant

4 weeks ago

Carson City, United States CVS Health Full time

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary 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 information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. Effective communication skills, both verbal and written Required Qualifications- 3+ years of experience as a Registered Nurse Must have active, current, and unrestricted RN licensure in state of residence- Must possess 1+ years of clinical experience in acute or post-acute setting Must be available to work Monday- through Friday in time zone of residence 8 AM – 5 PM Some holidays and weekends may be required per department needs Preferred Qualifications- 3+ years of clinical experience required- Managed Care experience preferredEducation Associates Degree BSN preferred Pay Range The typical pay range for this role is: $29.10 - $62.31 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits We anticipate the application window for this opening will close on: 05/21/2024 We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

  • Utilization Management Nurse Consultant

    3 weeks ago

    Jefferson City, United States CVS Health Full time

    Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we...

  • Consulting Utility Forester/ Utility Arborist

    3 weeks ago

    Panama City, United States Atlas Field Services Full time

    Job DescriptionJob DescriptionAtlas Field Services is actively scouting for Consulting Utility Foresters/ Utility Arborists to join our team as full-time employees. We are looking to fill this role in the following areas: Panama City, FL Who are we? We’re dedicated to the growth of our employees. We truly believe in your development. For those who show...

  • Senior Consultant, Professional Services

    1 week ago

    Carson City, United States Lucid Software Full time

    Lucid Software Senior Consultant, Professional Services Carson City , Nevada Apply Now Senior Consultant, Professional Services at Lucid Software Remote, US Lucid Software is the leader in visual collaboration, helping teams see and build the future from idea to reality. We hold true to our core values: innovation in everything we do, passion & excellence in...

  • Travel Nurse

    3 days ago

    Kansas City, United States Optum Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

  • Entry Level Management Consultant

    2 weeks ago

    Ellicott City, United States DreamCrafters Management Full time

    Job DescriptionJob DescriptionWho We Are: DreamCrafters Management a local firm that specializes in marketing, sales, and brand management for some of the most exciting and well-known companies in the world today. Simply put – DreamCrafters Management uses proven marketing methods and is responsible for bridging the gap between the services our clients...

  • Entry Level Management Consultant

    2 weeks ago

    Ellicott City, United States DreamCrafters Management Full time

    Job DescriptionJob DescriptionWho We Are: DreamCrafters Management a local firm that specializes in marketing, sales, and brand management for some of the most exciting and well-known companies in the world today. Simply put – DreamCrafters Management uses proven marketing methods and is responsible for bridging the gap between the services our clients...

  • Entry Level Management Consultant

    2 weeks ago

    Ellicott City, United States DreamCrafters Management Full time

    Job DescriptionJob DescriptionWho We Are: DreamCrafters Management a local firm that specializes in marketing, sales, and brand management for some of the most exciting and well-known companies in the world today. Simply put – DreamCrafters Management uses proven marketing methods and is responsible for bridging the gap between the services our clients...

  • Manager Utilization Management

    3 weeks ago

    Panorama City, United States Kaiser Permanente Full time

    **Job Summary**: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and...

  • Manager Utilization Management

    2 weeks ago

    Harbor City, United States Kaiser Permanente Full time

    **Job Summary**: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and...

  • Nursing Management Consultant

    4 weeks ago

    Neptune City, United States Hackensack Meridian Health Full time

    Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and...

  • Sales Consultant

    3 weeks ago

    Carson City, United States Northern Nevada Appliance Outlet, LTD Full time

    Job DescriptionJob DescriptionBenefits:Competitive salaryDental insuranceHealth insuranceVision insuranceJob SummaryNorthern Nevada Appliance Outlet, LTD is looking for a Sales Consultant to join our team! As a Sales Consultant, you will be the face of the company dealing with all customer questions about the product and services. It will be your job to keep...

  • Sales Consultant

    6 days ago

    Carson City, United States Northern Nevada Appliance Outlet, LTD Full time

    Job DescriptionJob DescriptionBenefits:Competitive salaryDental insuranceHealth insuranceVision insuranceJob SummaryNorthern Nevada Appliance Outlet, LTD is looking for a Sales Consultant to join our team! As a Sales Consultant, you will be the face of the company dealing with all customer questions about the product and services. It will be your job to keep...

  • Senior Technology Consultant

    3 weeks ago

    Carson City, United States Jacobs Full time

    Jacobs Senior Technology Consultant (Environmental Health and Safety Information Management) Carson City , Nevada Apply Now As a Senior Technology Consultant for Environmental Health and Safety Information Management, you'll have the chance to support the development and implementation of Environmental Health & Safety information management (aka EIMS, EMIS,...

  • Travel Nurse

    5 days ago

    Missouri City, United States Optum Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

  • Head Hunter

    2 weeks ago

    Redwood City, United States Synergy Management Group Full time

    Please Note: This is a remote independent contractor recruiting engagement. About Us:Synergy Management Group is a premier boutique consulting firm that specializes in providing outsourced/fractional corporate finance and growth strategy consulting services to institutional investors (private equity & venture capital), portfolio companies, and growing...

  • Sales Consultant

    6 days ago

    Carson City, United States Northern Nevada Appliance Outlet, LTD Full time

    Job DescriptionJob DescriptionBenefits:Competitive salaryDental insuranceHealth insurancePaid time offVision insuranceJob SummaryNorthern Nevada Appliance Outlet is looking for a Sales Consultant to join our team! As a Sales Consultant, you will be the face of the company dealing with all customer questions about the product and services. It will be your job...

  • Sales Consultant

    1 month ago

    Carson City, United States Northern Nevada Appliance Outlet, LTD Full time

    Job DescriptionJob DescriptionBenefits:Competitive salaryDental insuranceHealth insurancePaid time offVision insuranceJob SummaryNorthern Nevada Appliance Outlet is looking for a Sales Consultant to join our team! As a Sales Consultant, you will be the face of the company dealing with all customer questions about the product and services. It will be your job...

  • Director of Utilization Management

    1 week ago

    Panorama City, United States Kaiser Permanente Full time

    **Job Summary**: Develops, manages and directs the Utilization Management programs in a Service Area or a Medical Center. Develops and manages programs that emphasize appropriate admissions as well as concurrent and retrospective review of care. May also be responsible for other integrated functions such as Discharge Planning, Case Management program,...

  • SAP GRC Consultant

    1 month ago

    Carson City, United States The Dignify Solutions LLC Full time

    Responsibilities for SAP security consultant Leverage business and technical expertise to address technology architecture, blueprinting, data analysis, business modeling, technical design, application development, integration, and enablement Provide leadership and guidance to other systems analysts and client personnel assigned to the projects Have the...

  • Utility Investment Planning Project Manager

    1 month ago

    Kansas City, Missouri, United States Burns & McDonnell Full time

    DescriptionThe Utility Investment Planning Project manager will utilize extensive knowledge in electrical transmission and distribution systems to develop long-range investment plans for projects supporting electric utilities. The project manager will support a broad range of studies and other consulting services around aging infrastructure, system...