- Humana (Little Rock, AR)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- CenterWell (Little Rock, AR)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Little Rock, AR)
- **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
- CVS Health (Little Rock, AR)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Evolent (Little Rock, AR)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Sharecare (Little Rock, AR)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Community Health Systems (Bentonville, AR)
- …health, or nursing home setting required + 2-4 years of care management experience preferred **Knowledge, Skills and Abilities** + Strong understanding of case ... Offering up to a $20,000 Sign-On for eligible Full Time, Registered Nurse candidates! **Why Northwest Health?** We know it's not just about finding a job. It's about… more
- Community Health Systems (Springdale, AR)
- …health, or nursing home setting required + 2-4 years of care management experience preferred **Knowledge, Skills and Abilities** + Strong understanding of case ... coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role involves… more
- Wellpath (Tucker, AR)
- …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... discounts * Preferred banking partnership and discounted rates for home and auto loans *Eligibility for perks and benefits...+ Have and maintain current licensure as a Registered Nurse within the state of employment. + Obtain and… more