- CVS Health (Richmond, VA)
- … Management Nurse Consultant (UMNC) position is 100% remote. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and ... communicate all aspects of the utilization /benefit management program and our plan sponsor(s). You would...use of clinical tools and information/data review, the UM Nurse Consultant reviews services to assure medical necessity, applies… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- CVS Health (Harrisburg, PA)
- …to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the ... is approximately 1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and… more
- CVS Health (Austin, TX)
- …include weekends and holidays and evening rotations._ This is a full-time remote Utilization Management Nurse Consultant opportunity. As a Utilization ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case Management - Day (Temporary) Location: WellSpan Health, York, PA Schedule: Full Time Schedule Temporary Role ... geographic footprint. General Summary Performs a variety of reviews and applies utilization and case management techniques to determine the most efficient use of… more
- Humana (Dublin, OH)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- CVS Health (Raleigh, NC)
- …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in a collaborative process… more
- CVS Health (Austin, TX)
- …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 skills in ... to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal...residence + 3+ years of experience as a Registered Nurse + 1+ year(s) of Med/Surg experience + 1+… 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 Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary… more
- University of Washington (Seattle, WA)
- …) **UW Medical Center** has an outstanding opportunity for an **experienced Utilization Review Nurse (UM RN)** to join our team. **WORK ... Req #: 236354 Department: UW MEDICAL CENTER - UTILIZATION MANAGEMENT Job Location Detail: Position supports both...training + Active licensure to practice as a Registered Nurse in Washington State required by start date +… more
- Actalent (Santa Barbara, CA)
- …Health Plan Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract basis! ... to work a 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU: + Remote...with a leading healthcare organization Description: The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse … more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization... Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims… more
- Crouse Hospital (Syracuse, NY)
- …education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and ... 8:00am-4:30pm with occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse (RN) Position Responsibilities: + Works… 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 ... : Certified/certification eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses; Certification in… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned duties in… more
- 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 ... nursing experience in an acute hospital setting required and + 1 Year Utilization Management required and + Experience in case management, and/or the application of… 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 ... retrospective inpatient and outpatient services, in accordance with the utilization requirements and 3rd party payor contracts. The UM department is responsible for… more
- Matrix Providers (Aurora, CO)
- Registered Nurse (RN) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Registered Nurse (RN) - Utilization Management to join our team of talented professionals who provide… 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...required * Two or more years of experience in utilization management, preferably in Medicare Advantage or managed care… more
- CVS Health (Columbus, OH)
- …include weekends, holidays and evening hours._ This is a full-time remote Utilization Management opportunity. + Utilizes clinical experience and skills in a ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external… more
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