• Clinical Registered Nurse

    Cognizant (Boise, ID)
    …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
    Cognizant (12/23/25)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Boise, ID)
    **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse (RN)** in the (appropriate state)… more
    Humana (12/12/25)
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  • Clinical Reviewer, Nurse (Medical…

    Evolent (Boise, ID)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
    Evolent (12/10/25)
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  • Field Nurse Practitioner (Boise, ID)

    Molina Healthcare (Caldwell, ID)
    …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary... Practitioner will be required to work primarily in non- clinical settings and provide medical care to all levels… more
    Molina Healthcare (10/16/25)
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  • Field Nurse Practitioner (Pocatello, ID)

    Molina Healthcare (Caldwell, ID)
    …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
    Molina Healthcare (10/17/25)
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  • AVP, Healthcare Services

    Molina Healthcare (Caldwell, ID)
    …and experience. * At least 5 years health care management/leadership required. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical ... * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse (RN). License must be active and unrestricted… more
    Molina Healthcare (12/20/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Caldwell, ID)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
    Molina Healthcare (12/13/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Caldwell, ID)
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
    Molina Healthcare (11/23/25)
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  • Payment Integrity Clinician

    Highmark Health (Boise, ID)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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