• RN Utilization Management

    Humana (Jefferson City, MO)
    **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
    Humana (01/07/25)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Jefferson City, MO)
    …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
    Highmark Health (01/07/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Jefferson City, MO)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
    Sharecare (01/08/25)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Jefferson City, MO)
    …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
    Highmark Health (12/12/24)
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  • Utilization Management Nurse

    CVS Health (Jefferson City, MO)
    …operation. Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant you will be responsible for ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...work Monday through Friday 8:00am to 5pm CST + Utilization management is a 24/7 operation. Work… more
    CVS Health (01/09/25)
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  • Utilization Management Behavioral…

    Humana (Jefferson City, MO)
    …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
    Humana (11/13/24)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Jefferson City, MO)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
    Guardian Life (12/20/24)
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