• RN, Utilization Management

    Humana (Lexington, 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
    Humana (12/03/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    Humana (Dublin, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    CVS Health (Albany, NY)
    …weeks of training will be Monday through Friday, 8:00am to 5:00pm EST. As a Utilization Management Nurse Consultant you will utilize clinical experience and ... residence + 3+ years of experience as a Registered Nurse + 1+ year(s) of Med/Surg experience + 1+...to 7:00pm EST with holiday rotation per business needs. Utilization Management is a 24/7 operation and… more
    CVS Health (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    CVS Health (Montgomery, AL)
    …operation and work schedules may include weekends, holidays, and evening hours As a Utilization Management Nurse Consultant, you will utilize clinical skills ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
    CVS Health (01/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …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
    CVS Health (12/20/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    CVS Health (Trenton, NJ)
    …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
    CVS Health (01/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    Actalent (Santa Barbara, CA)
    …Title: Health Plan Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a ... to work a 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU:...with a leading healthcare organization Description: The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse more
    Actalent (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Review…

    Humana (Columbus, OH)
    …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (01/20/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management - Registered…

    Crouse Hospital (Syracuse, NY)
    …health education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage ... with occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse (RN) Position Responsibilities: + Works… more
    Crouse Hospital (11/30/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Management & Quality…

    UCLA Health (Los Angeles, CA)
    Description As the Utilization Management & Quality Review Nurse , you will be responsible for: + Ensuring appropriate, cost-effective, and high-quality care ... for New Century Health Plan members + Conducting utilization management (UM) activities in accordance with health plan policies and regulatory guidelines +… more
    UCLA Health (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Coordinator…

    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
    Trinity Health (11/29/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Utilization

    Aspen Medical (Aurora, CO)
    JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... Case Management through the American Nurses Credentialing Center or Utilization Management Accreditation through National Committee for Quality Assurance… more
    Aspen Medical (01/22/25)
    - Save Job - Related Jobs - Block Source
  • RN/Registered Nurse - Utilization

    Texas Health Resources (Arlington, TX)
    **RN/Registered Nurse - Utilization Management , Clinical Reviews** **Work location:** 100% remote but must live in Texas, preferably in the Dallas-Fort Worth ... an acute hospital setting required and + 1 Year Utilization Management required and + Experience in...criteria preferred **Licenses and Certifications** + RN - Registered Nurse Current license to practice professional nursing in the… more
    Texas Health Resources (01/16/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …Friday 8:00 am to 5:00 pm CST with rotating late evening and weekend shifts. Utilization Management is a 24/7 operation and work schedule may include weekends, ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + Must reside in… more
    CVS Health (01/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    Signature Healthcare (Louisville, KY)
    …communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health ... What you Need to make a Difference + Registered Nurse (RN) in good standing with required current state...Previous experience with MDS and assessment preferred Hospital Case Management /Hospital Utilization Management . Obtaining… more
    Signature Healthcare (01/09/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    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
    Katmai (01/18/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    US Tech Solutions (Columbia, SC)
    …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and ... and determine medical necessity criteria and contract benefits. Collaborates with Care Management and other areas to ensure proper care management processes… more
    US Tech Solutions (01/19/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse (RN) - Utilization

    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
    Matrix Providers (11/26/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Review RN (1.0 FTE)

    St. Peters Health (Helena, MT)
    The Utilization Management Nurse reports directly to Utilization Review RN Coordinator. The UR Nurse supports the UR RN Coordinator in providing ... for the organization and is responsible for ensuring complaint utilization and cost-effective care delivery. The UR Nurse...serves as a collaborative and supportive liaison and educator to providers and staff around utilization management more
    St. Peters Health (01/17/25)
    - Save Job - Related Jobs - Block Source
  • RN, Utilization Management

    University of Rochester (Strong, AR)
    …of the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: The Utilization Management Nurse role is a unique and ... Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management Work Shift: UR - Day (United States of America) Range: UR… more
    University of Rochester (01/03/25)
    - Save Job - Related Jobs - Block Source