Nurse Consultant
Provide high-quality clinical and regulatory consulting services to long-term care facilities nationwide. Manage assigned client accounts to ensure service quality, regulatory compliance, and achievement of profit and loss goals.
Remote Healthcare Jobs (38)
PO
Nurse Consultant
The Nurse Consultant will perform clinical and regulatory compliance audits, mock surveys, and medical-record reviews for client facilities nationwide. They are responsible for managing assigned client accounts, ensuring service quality, and providing practical recommendations to leadership.
Utilization Management (UM) Nurse Consultant - Work at Home in EST or CST Zone
The UM Nurse Consultant coordinates and documents the utilization and benefit management process to ensure members receive appropriate, safe, and effective care. They review clinical documentation, collaborate with providers, and evaluate healthcare services against established criteria and guidelines.
Utilization Management Nurse Consultant
Review clinical cases and make coverage determinations using evidence-based guidelines while collaborating with providers to coordinate treatment. Identify opportunities to improve care quality and serve as a clinical resource for internal and external stakeholders.
Prior Authorization UM Nurse Consultant
Review prior authorization requests and medical records to determine medical necessity using evidence-based clinical guidelines. Collaborate with providers, care managers, and interdisciplinary teams to ensure members receive high-quality, cost-effective care.
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Utilization Management Nurse Consultant
Review clinical information and apply evidence-based guidelines to support coverage and care decisions. Collaborate with providers and care teams to coordinate appropriate healthcare services and improve care quality.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates care plans with interdisciplinary teams. They serve as a clinical resource to ensure high-quality healthcare utilization and effective member-centered outcomes.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews and assesses clinical information to support coverage determinations and care decisions. They collaborate with interdisciplinary teams to coordinate treatment plans and identify opportunities for improved healthcare quality and member outcomes.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates healthcare services across the continuum of care. They collaborate with providers and care teams to facilitate appropriate treatment planning and identify opportunities to improve member outcomes.
Clinical Nurse Consultant- Washington, DC
The Clinical Nurse Consultant acts as a clinical expert to educate healthcare professionals on hematology and oncology products to optimize patient outcomes. They are responsible for developing professional relationships, delivering clinical exchanges, and supporting patient management protocols within their assigned territory.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information to make coverage recommendations and collaborates with healthcare providers to support quality patient outcomes. They also identify opportunities for care coordination and help members navigate their healthcare journey.
Nurse Consultant I (Nursing Home Surveyor) Guilford and surrounding
The Nurse Consultant conducts routine surveys and complaint investigations to ensure nursing homes comply with federal and state regulations. They are responsible for completing detailed survey reports and statements of deficiency.
Nurse Consultant (Acute/Home Care Section)
Conduct on-site surveys and documentation reviews to ensure compliance with state and federal regulations for home care and hospice agencies. Prepare deficiency reports, review plans of correction, and investigate public complaints regarding healthcare providers.
Nurse Consultant (Nursing Home Surveyor) Cabarrus, Rowan and surrounding areas
Conduct routine surveys and complaint investigations to determine nursing home compliance with federal and state requirements. Prepare detailed survey reports, including statements of deficiency and findings from complaint allegations.
Regional Child Health Nurse Consultant
The consultant serves as a primary resource for local health departments regarding child health needs, clinical services, and care management. Responsibilities include program planning, implementation, quality assurance, and providing training and consultation to regional agencies.
UM Nurse Consultant - Concurrent Review
Perform concurrent reviews for acute inpatient admissions to evaluate medical necessity and level of care using evidence-based criteria. Collaborate with interdisciplinary teams, including physicians and discharge planners, to facilitate appropriate treatment and timely transitions of care.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews and assesses clinical information to support coverage determinations and coordinates effective care plans. They collaborate with providers and care teams to promote quality, cost-effective healthcare outcomes for members.
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We watch for new "Nurse Consultant" jobs and email you the matches. Free. Unsubscribe in one click.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and assesses healthcare services across the continuum of care. They collaborate with providers and care teams to facilitate appropriate treatment planning and identify opportunities to improve member outcomes.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates healthcare services across the continuum of care. They also collaborate with interdisciplinary teams to facilitate treatment planning and connect members to appropriate health resources.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews and assesses clinical information to make coverage and care recommendations while applying clinical guidelines. They collaborate with providers and care teams to support treatment plans and identify opportunities for care management programs.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information to support coverage determinations and coordinates healthcare services across the continuum of care. They also collaborate with providers to facilitate appropriate treatment planning and connect members with necessary health resources.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical information and applies evidence-based criteria to make coverage recommendations for healthcare services. They also collaborate with interdisciplinary teams and providers to coordinate care and improve healthcare outcomes for members.
Utilization Management Nurse Consultant
The Utilization Management Nurse Consultant reviews clinical documentation to support coverage determinations and coordinates healthcare services across the continuum of care. They also collaborate with providers to facilitate treatment plans and identify opportunities to improve healthcare quality and benefit utilization.
Appeals Nurse Consultant (Remote)
The Appeals Nurse Consultant is responsible for reviewing and resolving clinical appeals by interpreting clinical records and applying appropriate criteria. They coordinate clinical resolutions with internal and external support to ensure fair and accurate outcomes.
Clinical Nurse Consultant- New York State
The Clinical Nurse Consultant develops professional relationships with healthcare providers to deliver clinical education and support for hematology and oncology products. They are responsible for driving peer-to-peer interactions, optimizing patient outcomes, and executing account-based business plans within their assigned territory.
Tele Forensic Nurse Consultant, Harborview Medical Center
Provide remote clinical consultation and forensic assessment support for sexual assault and domestic violence cases across Washington State. Participate in case reviews, quality assurance meetings, and maintain accurate documentation and evidence tracking.
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Nurse Consultant, Medical Office
The Nurse Consultant develops and implements strategies for life and health insurance claims, occupational health, and disability management. They analyze medical files, coordinate with practitioners to verify treatment plans, and negotiate return-to-work terms for insured individuals.
Utilization Management Nurse Consultant (UM) - Work at home in CST Zone
The UM Nurse Consultant coordinates and documents utilization and benefit management processes to ensure members receive appropriate, safe, and cost-effective care. They review clinical documentation, collaborate with providers, and facilitate discharge planning while adhering to state and federal requirements.
UM Nurse Consultant | Post Acute Specialty UM
Perform utilization management reviews and authorization activities for post-acute services to ensure medical necessity and cost-effective care. Collaborate with providers and interdisciplinary teams to facilitate timely care transitions for members.
Clinical Nurse Consultant- Philadelphia
The Clinical Nurse Consultant develops professional relationships with healthcare professionals to provide clinical education on hematology and oncology products. They drive peer-to-peer interactions to optimize patient outcomes and support the clinical management of patients receiving BMS therapies.
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