- CVS Health (Columbus, OH)
- …1 holiday per year).** There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote… more
- CVS Health (Harrisburg, PA)
- …of Saturday shift is approximately 1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the… more
- Humana (Frankfort, KY)
- …and help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to ... and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- CVS Health (Jefferson City, MO)
- …members sign up to work one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and...Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN… more
- System One (Baltimore, MD)
- ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Nurse to support a leading health insurance customer. The UM ... Nurse will perform prospective, concurrent and retrospective reviews for...coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mandates,… more
- Elevance Health (Washington, DC)
- The Utilization Management Nurse is responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member ... and minimum of 2 years acute care clinical experience. + Minimum 1 year Utilization Management experience preferred. For candidates working in person or remotely… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... department productivity to meet targets. + Participates in all aspects of utilization management . Assist with strategies, plans and workflow development in… more
- CVS Health (Carson City, NV)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... be licensed in all noncompact states. + 1 year of varied UM ( utilization management ) experience within an inpatient/outpatient setting, concurrent review or… more
- CVS Health (Raleigh, NC)
- …more personal, convenient and affordable. **Position Summary** **This is a fully remote Utilization Management opportunity.** Utilization management is a ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... convenient and affordable. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including every… more
- CVS Health (Phoenix, AZ)
- …experience working in a high volume clinical call center environment + 1+ year Utilization Management experience + 1+ years Managed Care experience + Remote work ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in… more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** -3+ years of ... preference for those residing in EST or CST. _Utilization Management is a 24/7 operation and work schedule may...experience as a Registered Nurse -Must hold active and unrestricted RN licensure in… more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... make health care more personal, convenient and affordable. _Utilization Management is a 24/7 operation and work schedule may...experience as a Registered Nurse + Must hold active and unrestricted RN licensure… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... licensed in Colorado, be able to practice using a nurse compact state license or have a license from...checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. **Medicare Clinical Predetermination position:** Utilization Management is a 24/7 operation and work schedule ... services and/or programs + Identifies opportunities to promote benefit utilization + Typical office working environment with productivity and...+ 3+ years of acute experience as a Registered Nurse + Must have active current and unrestricted RN… more
- CVS Health (Jefferson City, MO)
- …and external constituents in the coordination and administration of the utilization /benefit management function. - Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization - Consults and lends expertise to other internal...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... ratios and fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management to join our team of talented professionals… more
- CVS Health (Austin, TX)
- …to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote ... both) per the needs of the team.** The UM Nurse Consultant job duties include (not all encompassing): +...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience… more
- HCA Healthcare (Campbell, CA)
- …opportunity. We want your knowledge and expertise! **Job Summary and Qualifications** The ** Utilization Management Nurse ** 's primary function is to ensure ... the range. **Introduction** Do you have the career opportunities as a(an) ** Utilization Management RN** you want with your current employer? We have an exciting… more