Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Summary: Responsible for the day to day functions of the Utilization Management department inclusive of supervising Nurse Reviewers, and collaborating with Revenue Cycle and Business Office.
Summary: Responsible for the day to day functions of the Utilization Management department inclusive of supervising Nurse Reviewers, and collaborating with Revenue Cycle and Business Office.
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
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Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology company that ...
NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology company that ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Quick apply
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology company that ...
NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology company that ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
Overview NaphCare is hiring experienced Utilization Management Registered Nurse just like you at the Corporate Office located in Birmingham, AL. NaphCare is a family owned, healthcare technology ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
Quick apply
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach ... Sharing educational needs that are identified for providers and nursing to education department for ...
... utilization managers, medical social workers, bedside RNs, interdisciplinary teams, payers, and community resources, • Responsibilities include utilization management, care transitions planning ...
... utilization managers, medical social workers, bedside RNs, interdisciplinary teams, payers, and community resources, • Responsibilities include utilization management, care transitions planning ...
... MA RN license must be provided at the time of consideration, Additional Information • Responsibilities include utilization management, discharge planning, and coordinating care for inpatient ...
... MA RN license must be provided at the time of consideration, Additional Information • Responsibilities include utilization management, discharge planning, and coordinating care for inpatient ...
In Utilization Management at Main Campus Lee Building Summary: The UR Reviewer I is responsible for ... Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If ...
In Utilization Management at Main Campus Lee Building Summary: The UR Reviewer I is responsible for ... Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If ...
Weekday Cvs Utilization Management Nurse information
What are the key skills and qualifications needed to thrive as a Weekday CVS Utilization Management Nurse, and why are they important?
To thrive as a Weekday CVS Utilization Management Nurse, you need a valid RN license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with healthcare management software, insurance guidelines, and medical coding systems such as ICD-10 is typically required. Exceptional critical thinking, attention to detail, and effective communication help nurses advocate for appropriate patient care while collaborating with providers and payers. These skills ensure proper resource utilization, regulatory compliance, and optimal patient outcomes in a managed care setting.
How does a Weekday CVS Utilization Management Nurse typically collaborate with physicians and case managers?
As a Weekday CVS Utilization Management Nurse, you will regularly interact with physicians and case managers to review patient care plans and ensure appropriate resource utilization. This role involves evaluating medical records, discussing treatment options, and providing clinical recommendations to support cost-effective, quality care. Effective communication and teamwork are essential, as you’ll serve as a bridge between clinical staff, patients, and administrative teams to coordinate authorizations and resolve coverage questions.
What is a Weekday CVS Utilization Management Nurse?
A Weekday CVS Utilization Management Nurse is a registered nurse who works for CVS Health, focusing on evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient cases, coordinating with healthcare providers, and ensuring that treatments and services meet established guidelines and insurance requirements. These nurses typically work regular weekday hours, rather than nights or weekends. They play a key role in helping patients receive appropriate care while also managing healthcare costs for the organization.
What is the difference between Weekday Cvs Utilization Management Nurse vs Weekend Cvs Utilization Management Nurse?
| Aspect | Weekday Cvs Utilization Management Nurse | Weekend Cvs Utilization Management Nurse |
|---|---|---|
| Work Schedule | Monday to Friday, standard business hours | Weekend shifts, typically Saturday and Sunday |
| Certifications | RN license, utilization review certification often preferred | RN license, utilization review certification often preferred |
| Work Environment | Office-based, healthcare setting, insurance company | Office-based, healthcare setting, insurance company |
| Job Responsibilities | Review medical necessity, authorize services, coordinate care | Review medical necessity, authorize services, coordinate care |
The main difference between Weekday Cvs Utilization Management Nurse and Weekend Cvs Utilization Management Nurse lies in their work schedule. Both roles require similar certifications, responsibilities, and work environments, but the weekday nurse works during standard business hours, while the weekend nurse covers weekend shifts. Both positions are essential for continuous patient care and insurance operations.
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Job description
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
About Blue Eagle Consulting
Sourced by ZipRecruiter
Industry
It services
Company size
11 - 50 Employees
Headquarters location
Birmingham, AL, US
Year founded
2004