- Elliot Health System (Londonderry, NH)
- …Hospital takes great pride in serving their community, patients, and families. Our Nurse Case Managers observe best practices and strive to attain the best outcomes ... possible for their patients. If you are a nurse with strong clinical experience/skills and you love to...patients, but are seeking a change, please consider Case Management ! We will do on the job training for… 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 ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- Fallon Health (Worcester, MA)
- …a Registered Nurse in a clinical setting required. + 2 years' experience as a Utilization Management nurse in a managed care payer preferred. + One year ... **Overview** **About us :** Fallon Health is a company that cares....Twitter and LinkedIn. **Brief summary of purpose:** The UM Nurse uses a multidisciplinary approach to organize, coordinate, monitor,… more
- Actalent (Omaha, NE)
- Job Title: Utilization Management Nurse Qualifications + Compact RN license OR Nebraska RN license + Bachelor's degree in Nursing + Must have previous UM ... Description We are seeking a dedicated and detail-oriented Registered Nurse for Utilization Management . The...30,000 consultants and more than 4,500 clients across the US , Canada, Asia and Europe, Actalent serves many of… more
- CoreCivic (Brentwood, TN)
- …to better the public good. CoreCivic is currently seeking a ** Utilization Management / Case Management Nurse ** located at our corporate office in ... remote out of our Brentwood, TN office location._ The Utilization Management /Case Management Nurse...utilizes the information to facilitate process improvement. + Domestic US travel may be required. **Qualifications:** + Graduate from… 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 ... providing temporary contracted medical services to Military Treatment Facilities throughout the United States . Today's posting will place you at the primary… more
- US Tech Solutions (Canton, MA)
- …all aspects of clinical decision making and support needed to perform utilization management , medical necessity determinations and benefit determinations using ... criteria through participation in the IMPAC. + Proactively identifies trends in Utilization Management applicable to the precertification and outpatient UM… 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 ... using a nurse compact state license or have a license from any United States jurisdiction (with no limitations, stipulations or pending adverse actions). +… more
- CVS Health (Columbus, OH)
- …**Required Qualifications:** -3+ Years of clinical experience -1+ Year of Utilization Review Management and/or Medical Management experience. ... every day. This position will be remote working from home anywhere in the US . **Schedule is Monday - Friday 8am-5pm est.** No travel required. Non-exempt. Hourly.… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and… more
- CVS Health (Phoenix, AZ)
- …time zone. No weekends, holidays are required. **Preferred Qualifications** : + Utilization management experience + Clinical experience in Emergency Department, ... Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose:...to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and… more
- UCLA Health (Los Angeles, CA)
- …leader with: + Current CA LVN licensure required + Two or more years of utilization review/ utilization management experience in an HMO, MSO, IPA, or health ... gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart. more
- Actalent (Houston, TX)
- … Management NurseJob Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to oversee and review both handwritten and ... for inpatient stays, managing authorizations, and effectively communicating with the Utilization Management department at hospitals. Responsibilities + Review… more
- Actalent (Dallas, TX)
- …Utilization Management NurseJob Description We are seeking a dedicated Utilization Management Nurse to review handwritten and computer-generated ... documents, ensuring tasks are prioritized effectively. The nurse will be responsible for assessing medical necessity for...for an inpatient stay. + Follow up with the Utilization Management department at hospitals by phone… more
- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... (Outlined in Handbook) + 401(k) Plan Minimum Requirements Registered Nurse (RN) Utilization Management : Degree/Education:...to all users. If you would like to contact us regarding the accessibility of our website or need… more
- Fallon Health (Worcester, MA)
- … Nurse in a clinical setting required. * 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. * ... **Overview** **About us :** Fallon Health is a company that cares....Twitter and LinkedIn. **Brief summary of purpose:** The PA Nurse uses a multidisciplinary approach to review service requests… more
- Humana (Oklahoma City, OK)
- … put health first** Humana Healthy Horizons in Oklahoma is seeking a Manager, Utilization Management (UM) Physical Health Nurse , who utilizes clinical ... in the State of Oklahoma.** + 2+ years of leadership/ management experience. + Licensed Registered Nurse (RN)...skilled or rehabilitation clinical setting. + 2+ years of utilization management experience. + Experience leading UM… more
- ManpowerGroup (Columbia, SC)
- ** Utilization Management Nurse / Social Worker (Contract Position)** **Location:** Remote (Must Train Onsite for 1-2 Weeks) - Must Reside Within 3 Hours of ... Format:** Microsoft Teams **Job Overview** We are seeking a ** Utilization Management Nurse or Licensed...**OR** LBSW (Licensed Bachelor of Social Work) in the US and state of hire. **Preferred Qualifications** **Education:** +… more
- Omaha Children's Hospital (Omaha, NE)
- …meets department guidelines, standards, and policies. + Communicates and collaborates with the Utilization Management (UM) Nurse , or other NCMs as necessary ... region's only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your...for diagnosis, care needs, and discharge plans. + Introduces Nurse Case Management (NCM) role to family.… more
- Trinity Health (Troy, NY)
- …requirements for Utilization Management and works collaboratively with Utilization Management /Concurrent Review Nurse , physicians, staff and other ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management /Concurrent Review Nurse within identified… more
