Clinical Utilization Management Nurse Specialist

Position Overview:Under the supervision of the Manager of the Utilization Review Program, the Utilization Review (UR) Nurse plays a crucial role in ensuring the efficient and precise evaluation of initial medical necessity assessments throughout the preauthorization and retrospective review processes.Work Environment:This position is remote; however, due to...

Position Overview:Under the guidance of the Manager of the Utilization Review Program, the Utilization Review (UR) Nurse plays a crucial role in ensuring the efficient and precise management of initial medical necessity evaluations throughout the preauthorization and retrospective review processes.Work Environment:This position is primarily remote; however,...

Position Overview:Under the supervision of the Manager of the Utilization Review Program, the Utilization Review (UR) Nurse plays a crucial role in ensuring the efficient and precise management of initial medical necessity evaluations throughout the preauthorization and retrospective review processes.Work Environment:This position is remote; however, due to...

About CVS HealthAt CVS Health, we are united by a common mission: to bring compassion to every aspect of health care. Our commitment is to provide personalized, accessible, and affordable health solutions in a rapidly evolving landscape.Position OverviewThis role as a Utilization Management Nurse Consultant is entirely remote, allowing flexibility for...

Position Overview:Under the supervision of the Manager of the Utilization Review Program, the Clinical Review Nurse is tasked with ensuring timely and precise evaluation of initial medical necessity assessments throughout the preauthorization and retrospective review processes.Work Environment:This role is designated as remote; however, due to payroll and...

About UsNeuropsychiatric Hospitals is a leading healthcare provider with a unique approach to patient care. Our hospitals offer a comprehensive range of services, including neuropsychiatric and complex medical care, to patients with diverse needs.Job SummaryWe are seeking a highly skilled Utilization Review Specialist to join our team. As a Utilization...

The UM Clinical Support Specialist plays a vital role in assisting the Director and Supervisor of UM by collecting, analyzing, and reporting data. This role involves maintaining data logs related to utilization and productivity, developing and monitoring various reports, and providing support to the clinical team by handling inbound and outbound calls that...

BARROW BRAIN AND SPINEClinical Nurse Specialist (CNS)ARE YOU READY TO JOIN OUR EXCEPTIONAL TEAM?At Barrow Brain and Spine, our team members are committed to the highest standards of performance, integrity, collaboration, and dedication to patient care. This is not merely a statement; it embodies our culture. If you seek an extraordinary work environment...

Position Overview: We are in search of a dedicated Clinical Nurse Specialist with expertise in Labor and Delivery to join our team for a temporary assignment. Key Responsibilities: Provide exceptional nursing care to patients in the Labor and Delivery unit. Collaborate with healthcare professionals to ensure optimal patient outcomes. Utilize advanced...

About the RoleWe are seeking a highly skilled Clinical Risk Management Specialist to join our team at Arthur J Gallagher & Co. As a key member of our global brokerage team, you will play a critical role in addressing risk head-on and safeguarding businesses.Key ResponsibilitiesMonitor and Analyze Benefit Utilization: Ensure the accuracy and effectiveness of...

Position Overview: We are in search of a dedicated Clinical Nurse Specialist with expertise in the Progressive Care Unit for a temporary assignment. About MAS Medical Staffing: Our organization is committed to providing exceptional travel opportunities for healthcare professionals. We pride ourselves on connecting skilled nurses with rewarding positions that...

Position Overview:The Senior Clinical Nurse Specialist (CNS) plays a pivotal role in enhancing healthcare delivery within the organization. This position operates under minimal supervision, leveraging expertise to influence patient care, staff development, and systemic improvements.Key Responsibilities:Utilizes evidence-based knowledge to maintain clinical...

About CVS HealthAt CVS Health, we are dedicated to a singular mission: to enhance every moment of your health journey. Our commitment is to provide human-centric healthcare solutions in a rapidly evolving landscape. We believe that the manner in which we deliver our services is as crucial as the services themselves. Our Heart At Work Behaviors embody this...

As a Public Utilities Specialist (Power Contracts & Energy Services), you will:Serve as a principal expert/project manager for developing and negotiating unique/complex multi-functional contracts for which there may be no contractual precedents or existing policy. Develop and implement new policies and procedures. Routinely represent Western in presenting...

Position: Clinical Nurse SpecialistOverview: As a Clinical Nurse Specialist, you will play a vital role in delivering high-quality healthcare to the senior demographic. Your expertise will be essential in ensuring comprehensive patient care and support.Key Responsibilities:Deliver exceptional patient care tailored to the needs of the elderly.Employ the...

As a Public Utilities Specialist Load and Resource Portfolio Manager, you will:Be responsible for the marketing of power and for the portfolio management for Desert Southwest Region's (DSW) customer accounts and Federal Projects. Serve as an account representative for customers, customer groupings, and Federal Projects and is responsible for ensuring the...

Lead Utility Operations SpecialistThe Lead Utility Operations Specialist is responsible for overseeing the upkeep and sanitation of both front and back of house facilities. Key duties include mentoring and directing utility personnel, ensuring the cleanliness of dishes and kitchen tools, and confirming that all equipment is sanitized and functional. This...

About UsNeuroPsychiatric Hospitals is a leading healthcare provider with a unique approach to patient care. Our hospitals offer a comprehensive range of services, including neuropsychiatric and complex medical care, to patients with diverse needs.Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team. As a key member of...

Job SummaryThe Clinical Documentation Specialist will provide expert-level review of inpatient clinical records to identify gaps in clinical documentation that need clarification for accurate code assignment. This role will work closely with providers to obtain needed documentation specificity and provide leadership for overall improvement in clinical...

About the RoleOptum 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...