Management Consultant Jobs

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Medicare Clinical Predetermination Nurse Must be willing and able to work Monday through Friday, 9am - 5:30pm EST or CST with occasional holiday rotation. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours. 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. Required Qualifications 3+ years of experi

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare- Complex Spine Team) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your clinical expertise to ensure members receive the right care at the right time. What You’ll Do Review clinical cases and make coverage determinations using evidence-based guidelines Collaborate with providers and care teams to coordinate appropriate treatment Apply clinical judgment to support utilization and benefit management decisions Identify opportunities to improve care quality and member outcomes Serve as a clinical resource across internal and external stakeholders What You Bring - REQUIRED Active, unrestricted RN license in the state of residence. 3+ years of RN experience, including 1+ year in Med/Surg Strong clinical assessment and decision-making skills Experience with Microsoft Office (Outlook, Teams, Excel) Ability to work Monday–Friday, 9:00 AM–5:30 PM in your time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours Associate Degree in Nursing Nice to Have Utilization Management or Prior Authorization experience Manage

Celonis is the trusted platform to industrialize Enterprise AI. At our core is the Celonis Context Model — which combines process data, business knowledge, and intelligence into a living digital twin of the enterprise that AI can actually understand, turning AI's operational blind spots into operational clarity. World's leading companies trust Celonis and its global ecosystem of partners to make their AI agents, people, systems, and processes work together, achieving transformational outcomes. We believe there's a massive opportunity to unlock global productivity and sustainability by giving AI the context to understand how every business process really works. Join our mission to make processes work for people, companies, and the planet. The position of the Senior Management & Technology Consultant - Manufacturing/Production (Internal Title: Senior Value Engineer ) is a trusted advisor helping customers achieve their strategic goals and realise significant value using the Celonis Process Intelligence Platform. A Value Engineer has full responsibility for the end-to-end value journey of our customers – landing, expanding, adopting and renewing. Responsibilities include translating customers’ objectives into value assessments or proof-of-value projects, building specific Celonis business cases and demos, running value workshops, and engaging with multiple senior stakeholders to deliver value driven results and secure long term partnership agreements. The Role: You are spearheading our mission of data-driven business transformation with our customers. You will work in partnership with the Celonis Sales Teams and have full responsibility for the end-to-end value journey of our customers. You are our customers' trusted advisor and help them achieve their strategic goals and realize significant value using Celonis Process Intelligence Platform. In collaboration with our partners and Celonis Services, you will drive measurable business impact across various proces

Celonis is the trusted platform to industrialize Enterprise AI. At our core is the Celonis Context Model — which combines process data, business knowledge, and intelligence into a living digital twin of the enterprise that AI can actually understand, turning AI's operational blind spots into operational clarity. World's leading companies trust Celonis and its global ecosystem of partners to make their AI agents, people, systems, and processes work together, achieving transformational outcomes. We believe there's a massive opportunity to unlock global productivity and sustainability by giving AI the context to understand how every business process really works. Join our mission to make processes work for people, companies, and the planet. The position of the Senior Management & Technology Consultant - Aviation/Logistics (internal title: Senior Value Engineer) is a trusted advisor helping customers achieve their strategic goals and realise significant value using the Celonis Process Intelligence Platform. A Value Engineer has full responsibility for the end-to-end value journey of our customers – landing, expanding, adopting and renewing. Responsibilities include translating customers’ objectives into value assessments or proof-of-value projects, building specific Celonis business cases and demos, running value workshops, and engaging with multiple senior stakeholders to deliver value driven results and secure long term partnership agreements. The Role: You are spearheading our mission of data-driven business transformation with our customers. You will work in partnership with the Celonis Sales Teams and have full responsibility for the end-to-end value journey of our customers. You are our customers' trusted advisor and help them achieve their strategic goals and realize significant value using Celonis Process Intelligence Platform. In collaboration with our partners and Celonis Services, you will drive measurable business impact across various processes an

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Preference for those residing in mountain or pacific time zones. 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 sit

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your clinical expertise to ensure members receive the right care at the right time. What You’ll Do Review clinical cases and make coverage determinations using evidence-based guidelines Collaborate with providers and care teams to coordinate appropriate treatment Apply clinical judgment to support utilization and benefit management decisions Identify opportunities to improve care quality and member outcomes Serve as a clinical resource across internal and external stakeholders What You Bring - REQUIRED Active, unrestricted RN license in the state of residence. 3&#43; years of RN experience, including 1&#43; year in Med/Surg Strong clinical assessment and decision-making skills Experience with Microsoft Office (Outlook, Teams, Excel) Ability to work Monday–Friday, 9:00 AM–6:00 PM in your time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours Associate Degree in Nursing Nice to Have Utilization Management or Prior Authorization experience Managed care background</l

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant (RN) Make a meaningful impact on patient care from wherever you are. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you will use your clinical expertise to review healthcare services, support appropriate care decisions, collaborate with providers, and help members navigate their healthcare journey. What You'll Do Review clinical information and apply evidence-based criteria to make coverage recommendations. Collaborate with healthcare providers and internal teams to support quality patient outcomes. Identify opportunities for care coordination and member support programs. Promote effective healthcare utilization and contribute to high-quality service delivery. Manage multiple systems and priorities in a fast-paced, team-oriented environment. Required Qualifications Active, unrestricted RN license in your state of residence. Minimum 2 years of RN experience in an adult acute care or critical care setting . Associate's Degree in Nursing. Strong communication, computer, and multitasking skills. Ability to work schedules that may include evenings, weekends, and holidays as part of a 24/7 operation. Preferred Qualificatio

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) - Utilization Management Location: Remote (Preference for candidates in Central or Eastern Time Zones) Schedule: 24/7 operation; includes evenings, weekends, and holidays Are you an experienced Registered Nurse looking to leverage your clinical expertise in a collaborative, fast-paced environment? Join our Utilization Management team and play a critical role in ensuring members receive appropriate, high-quality healthcare services across the continuum of care. What You'll Do Review and assess clinical information to support coverage determinations and care recommendations. Apply clinical guidelines, policies, and professional judgment to utilization management decisions. Collaborate with providers and interdisciplinary teams to coordinate care and treatment plans. Identify opportunities for care management referrals and enhanced member support services. Promote quality outcomes, effective healthcare utilization, and member-centered care. Serve as a clinical resource for internal and external stakeholders. Required Qualifications Active, unrestricted RN license in your state of residence. 2&#43; years of RN experience in adult acute care or critical care settings. Associate Degree in Nursing (ADN). Strong communication, critica

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | Eastern Time Zone Preferred Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive the right care at the right time through evidence-based clinical review, care coordination, and healthcare advocacy. What You'll Do Review clinical information and apply established guidelines, policies, and clinical judgment to support coverage determinations Assess, coordinate, monitor, and evaluate healthcare services and benefits across the continuum of care Collaborate with providers and care teams to facilitate appropriate treatment and care planning Identify opportunities to improve quality of care, member outcomes, and healthcare utilization Connect members with additional programs and resources that support their healthcare needs Serve as a clinical resource for internal and external stakeholders WHAT YOU BRING - REQUIRED Active, unrestricted RN license in your state of residence 2&#43; years of adult acute care and/or critical care nursing experience Strong clinical assessment, critical thinking, and decision-making skills Excellent verbal and written communication skills Ability to multitask and

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse (RN) – Utilization Management Remote | Work from Home | Eastern Time Zone Preferred Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive the right care at the right time through evidence-based clinical review, care coordination, and healthcare advocacy. What You'll Do Review clinical information and apply established guidelines, policies, and clinical judgment to support coverage determinations Assess, coordinate, monitor, and evaluate healthcare services and benefits across the continuum of care Collaborate with providers and care teams to facilitate appropriate treatment and care planning Identify opportunities to improve quality of care, member outcomes, and healthcare utilization Connect members with additional programs and resources that support their healthcare needs Serve as a clinical resource for internal and external stakeholders WHAT YOU BRING - REQUIRED Active, unrestricted RN license in your state of residence 2&#43; years of adult acute care and/or critical care nursing experience Strong clinical assessment, critical thinking, and decision-making skills Excellent verbal and written communication skills Ability to multitask and

Utilization Management Nurse Consultant — GA - Work from home. Apply via Workday.

Celonis is the trusted platform to industrialize Enterprise AI. At our core is the Celonis Context Model — which combines process data, business knowledge, and intelligence into a living digital twin of the enterprise that AI can actually understand, turning AI's operational blind spots into operational clarity. World's leading companies trust Celonis and its global ecosystem of partners to make their AI agents, people, systems, and processes work together, achieving transformational outcomes. We believe there's a massive opportunity to unlock global productivity and sustainability by giving AI the context to understand how every business process really works. Join our mission to make processes work for people, companies, and the planet. The position of the Senior Management & Technology Consultant - Manufacturing/Production (Internal Title: Senior Value Engineer ) is a trusted advisor helping customers achieve their strategic goals and realise significant value using the Celonis Process Intelligence Platform. A Value Engineer has full responsibility for the end-to-end value journey of our customers – landing, expanding, adopting and renewing. Responsibilities include translating customers’ objectives into value assessments or proof-of-value projects, building specific Celonis business cases and demos, running value workshops, and engaging with multiple senior stakeholders to deliver value driven results and secure long term partnership agreements. The Role: You are spearheading our mission of data-driven business transformation with our customers. You will work in partnership with the Celonis Sales Teams and have full responsibility for the end-to-end value journey of our customers. You are our customers' trusted advisor and help them achieve their strategic goals and realize significant value using Celonis Process Intelligence Platform. In collaboration with our partners and Celonis Services, you will drive measurable business impact across various proces

Utilization Management Nurse Consultant — PA - Work from home. Apply via Workday.

Utilization Management Nurse Consultant — CA - Work from home. Apply via Workday.

Utilization Management Nurse Consultant — KS - Work from home. Apply via Workday.