- CVS Health (Olympia, WA)
- …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 (Austin, TX)
- …may include weekends and holidays and evening rotations._ This is a full-time remote Utilization Management Nurse Consultant opportunity. As a Utilization ... residence with 6 weekends per year with rotating Holidays. Utilization management is a 24/7 operation. Work...and/or Critical care setting + Managed Care experience + Utilization review experience + Experience working with… 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 ... to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote… more
- CVS Health (Columbus, OH)
- …This is a full-time remote Utilization Management opportunity. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work...time zone of work being supported **Preferred Qualifications** + Utilization review experience + Medicare experience +… more
- Humana (Jackson, MS)
- **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
- 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 ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Humana (Baton Rouge, LA)
- …independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review Post-Acute Preauth cases using ... part of our caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills to support the coordination,… more
- CVS Health (Richmond, VA)
- …to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% ... remote. As a Utilization Nurse Consultant, you will utilize clinical...suites experience including Outlook and Excel **Preferred Qualifications** + Utilization Review experience + Managed Care experience… more
- 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:... activities, which may include telephonic or onsite clinical review ; case or disease management , care coordination… more
- 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)...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
- 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
- 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
- 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 ... eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses;...in a direct patient care clinical setting. Must have utilization management , utilization review… more
- CVS Health (Carson City, NV)
- …all noncompact states. + 1 year of varied UM ( utilization management ) experience within an inpatient/outpatient setting, concurrent review or prior ... Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management… more
- CVS Health (Hartford, CT)
- …Qualifications** + Must reside within the Eastern or Central time zone + Utilization management is a 24/7 operation. Work schedules will include weekends ... Outlook, Word, and Excel **Preferred Qualifications** + Managed Care experience + Utilization review experience + Experience working with Medicare members +… more
- CVS Health (Austin, TX)
- …Nurse **Preferred Qualifications** + Clinical experience in post-acute setting + Prior utilization review or case management experience + Managed Care ... training sessions or other events, as directed by their Leader. - Utilization Management is a 24/7 operation and the work schedule will include weekends,… 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 ... background checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional in… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management ...care clinical setting and 12 months consecutive experience in utilization management , utilization review… more
- AdventHealth (Altamonte Springs, FL)
- …avoidance strategies including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a designated ... **The role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ...of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,… more
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