- CVS Health (Columbus, OH)
- …work schedule may include weekends, holidays and evening hours._ This is a full time remote Utilization Management opportunity. As a Utilization ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
- CVS Health (Hartford, CT)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. ... include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant, you...of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical… more
- CVS Health (Jefferson City, MO)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. ... external constituents in the coordination and administration of the utilization /benefit management function. * Typical office working...of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical… more
- CVS Health (Tallahassee, FL)
- …care more personal, convenient and affordable. **Position Summary** **This is a fully remote Utilization Management opportunity.** Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current… more
- CVS Health (Charleston, WV)
- …schedules may include weekends and holidays and evening rotations._ This is a fully remote Utilization Management Nurse Consultant opportunity. The ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...Qualifications** + 2+ years of clinical experience as an RN + Must have active, current, and unrestricted … more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …used while maintaining quality of care. Responsibilities The Registered Nurse ( RN ) - Utilization Management (UM) is responsible for reviewing all ... VA Medical Center has a full-time Registered Nurse - Utilization Management position...to clinical and administrative staff for UM issues. This RN delivers fundamental knowledge-based care to assigned clients while… more
- Humana (Louisville, KY)
- **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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** Utilization Management Nurse - Weekend Front End Review utilizes clinical nursing ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in Florida… more
- Mayo Clinic (Rochester, MN)
- …and inclusion, and provides the resources you need to succeed. **Responsibilities** The Registered Nurse ( RN ) Case Manager works within an interdisciplinary ... by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function… more
- Healthfirst (NY)
- **Duties/Responsibilities:** + Provides case management services for assigned member caseloads which includes: + Pre-certification performing risk-identification, ... Negotiates rates with non-partner providers, where applicable. Ensures appropriate access and utilization of a full continuum of network and community resources to… more
- Marshfield Clinic (Marshfield, WI)
- …am - 5:00 pm (United States of America) **Job Description:** **JOB SUMMARY** The Care Management Registered Nurse ( RN ) functions as an integral member ... Title:** Registered Nurse - Care Management - SHP ( Remote ) **Cost Center:** 682891395...Management Team of Security Health Plan. The Care Management RN is responsible for the assessment,… more
- Banner Health (Gilbert, AZ)
- …include working in an acute care setting within the past 12 months as a Registered Nurse in the specialty area. Banner Registry and Travel physician practice ... (HUC). Clinical Care Operations is the hub of patient management for the campus, including: bed assignment, unit staffing...require a minimum of one year experience as a Registered Nurse in a physician practice or… more
- Banner Health (Gilbert, AZ)
- …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... Apply today. Our Care Coordination staff is seeking an RN Case Manager to work closely with patients and...regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained… more
- Geisinger (Danville, PA)
- …nurses to offer remote , systemwide support, through a 24/7 virtual nurse center. Virtual registered nurses (VRNs) handle admissions, discharges and virtual ... is proud to offer a full time Virtual Inpatient RN a $30.40 minimum hiring rate with increased rates...Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania;… more
- Geisinger (Wilkes-Barre, PA)
- …Advanced Cardiac Life Support Certification - American Heart Association (AHA); Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $26,000 hiring incentive for eligible candidates! $37.04 minimum hiring rate with increased… more
- Geisinger (Wilkes-Barre, PA)
- …(Required), Bachelor's Degree-Nursing (Preferred) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer an Inpatient RN a hiring incentive up to $26,000 for eligible candidates! $35.88 minimum hiring rate with increased rates for… more
- Geisinger (Danville, PA)
- …Specialty Training Program-Nursing (Required) Experience Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; ... Job Summary Geisinger is proud to offer a full time Inpatient RN up to $24,000 hiring incentive for eligible candidates! $40.00 minimum hiring rate with increased… more
- AmeriHealth Caritas (Myrtle Beach, SC)
- ** REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Myrtle Beach, SC Primary Job Function: Medical Management ID**: ... accurate documentation of Member interactions in ACFC electronic care management platforms where applicable. 6. Monitor appropriate utilization...is required and must hold a current and unrestricted ** Registered Nurse ( RN )** license in… more
- Veterans Affairs, Veterans Health Administration (Wilkes Barre, PA)
- …VA Medical Center is currently recruiting for a Perioperative Operating Room (OR) Registered Nurse ( RN ). Responsibilities The Perioperative Operating Room ... (OR) Registered Nurse ( RN ) is accountable for patient outcomes...responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice… more
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... required depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case … more