• Utilization Review RN

    St. Peters Health (Helena, MT)
    The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR ... denials as assigned, and participation in the organizations Utilization Review Committee. In collaboration with the patient /family, physicians, and the… more
    St. Peters Health (12/11/25)
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  • Clinical Registered Nurse

    Cognizant (Helena, MT)
    …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,… more
    Cognizant (12/23/25)
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  • SNF Utilization Management RN

    Humana (Helena, MT)
    …an impact** **Use your skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
    Humana (12/12/25)
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  • Behavioral Health Care Coordinator

    Health Care Service Corporation (Helena, MT)
    …to acute in- patient to out- patient office visits. **JOB REQUIREMENTS:** * Registered Nurse ( RN ) or Masters-level Behavioral Health Professional (LPC, ... skills. *PC and database experience. **PREFERRED JOB REQUIREMENTS:** * Utilization review experience. *MUST be licensed to...of years) at the independent practice level *If a Registered Nurse ( RN ): must have… more
    Health Care Service Corporation (12/23/25)
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  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent (Helena, MT)
    …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
    Evolent (12/10/25)
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