Management Consulting Jobs

Position Summary: OhioRISE manages the behavioral health benefit for eligible children and young adults receiving Medicaid services in Ohio. The Behavioral Health UM Clinician position is designed to clinically review of behavioral health prior authorized services for assigned…

Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to…

Schedule Monday-Friday 8a-5p EST/CST Position Summary Applies specialized clinical and industry knowledge and performance improvement best practices to quality improvement efforts . Analyzes workflow and organizational performance to evaluate effectiveness of interventions and…

Registered Nurse (RN) – Utilization Management Remote | Work from Home | 24/7 Operations Are you an experienced Registered Nurse looking to apply your clinical expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive the right care at…

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…

Position Information Schedule: Monday–Friday 8:00am-5:00pm EST About Us American Health Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care management solutions that…

Registered Nurse (RN) - Utilization Management Schedule: 24/7 operation requiring flexibility for evenings, weekends, and holidays Are you an experienced RN looking to leverage your clinical expertise in a dynamic, collaborative environment? Join our Utilization Management team…

Job Summary The Utilization Management Nurse supports the effective coordination and management of healthcare services by reviewing clinical information, determining medical necessity, facilitating appropriate resource utilization, and ensuring compliance with regulatory and…

Utilization Management Nurse Consultant - Medical Review (Remote) at CVS Health in Work At Home Missouri, United States. Remote.

Registered Nurse (RN) Utilization Management Nurse Consultant - Remote Make a difference in patient care from the comfort of home. We're seeking experienced Registered Nurses to join our Utilization Management team in a fully remote role. In this position, you'll leverage your…

Utilization Management Nurse Consultant at CVS Health in Work From Home, United States. Remote.

Registered Nurse - Utilization Management (Remote) Make a difference in patient care while leveraging your clinical expertise in a dynamic, collaborative environment. We are seeking an experienced Registered Nurse (RN) to join our Utilization Management team. In this role, you…

Position Summary Schedule is Monday through Friday, 9:00am to 5:30pm in the candidate's time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours. Medicare Precertification Utilization Management Nurse Consultant position:…

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…