• Registered Nurse ( RN )…

    Matrix Providers (Aurora, CO)
    Registered Nurse ( RN ) - Utilization Management Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... schedules. Matrix Providers is hiring a Registered Nurse ( RN ) - Utilization Management to join our team of talented professionals who provide… more
    Matrix Providers (11/26/24)
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  • RN - Utilization Management

    ERP International (Nellis AFB, NV)
    **Overview** ERP International is seeking ** Registered Nurse ( RN ) Utilization Managers** for full-time positions in support of theMike O'Callaghan ... No Call, No Weekends, No Holidays! **Job Specific Position Duties:** * Provides Utilization Management activities and functions by using MTF specific Quality… more
    ERP International (11/02/24)
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  • UMII Transfer and Admission - Utilization

    Sharp HealthCare (San Diego, CA)
    …**Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... care and supports other members of the System Centralized Utilization Management team to ensure final status...clinical experience as defined by the CBA. + California Registered Nurse ( RN ) - CA… more
    Sharp HealthCare (09/06/24)
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  • Utilization Management Director…

    CareFirst (Baltimore, MD)
    …is required in addition to the required work experience. **Licenses/Certifications:** + Health Services\ RN - Registered Nurse - State Licensure and/or ... based on business needs and work activities/deliverables that week. The Director, Utilization Management provides strategic leadership of the utilization more
    CareFirst (11/26/24)
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  • Per Diem RN - Utilization

    Sharp HealthCare (San Diego, CA)
    …Degree in Nursing; Certified Case Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA Board of Registered ... Care Management (ICM) team the Per Diem RN (Adv CN)-Unit A4 position supports utilization ...clinical experience as defined by the CBA. + California Registered Nurse ( RN ) - CA… more
    Sharp HealthCare (11/02/24)
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  • SRS-Inpatient Case Manager II - Utilization

    Sharp HealthCare (San Diego, CA)
    …recent case management , utilization review, care coordination experience + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
    Sharp HealthCare (10/30/24)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …1 holiday per year).** There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... to make health care more personal, convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is fully remote… more
    CVS Health (11/27/24)
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  • Utilization Management Nurse

    CVS Health (Harrisburg, PA)
    …of Saturday shift is approximately 1 per month.** No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote… more
    CVS Health (11/27/24)
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  • Market Director of Utilization

    Ascension Health (Nashville, TN)
    **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Tennessee Board… more
    Ascension Health (10/25/24)
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  • Care Coordinator, Utilization

    Hackensack Meridian Health (Neptune, NJ)
    …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
    Hackensack Meridian Health (11/15/24)
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  • Care Coordinator, Utilization

    Hackensack Meridian Health (Holmdel, NJ)
    …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
    Hackensack Meridian Health (11/14/24)
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  • RN Registered Nurse Director…

    Ascension Health (Tulsa, OK)
    **Details** + **Department:** Utilization Management + **Schedule:** FT, Monday-Friday, 8am-5pm + **Hospital:** Ascension St. John Medical Center + **Location:** ... Provide strategic direction and oversight of the day-to-day operations of utilization management function within the insurance plan. Responsibilities: +… more
    Ascension Health (11/21/24)
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  • Utilization Management Reviewer…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …medical necessity criteria and BCBSMA policies and procedures + Focus on efficient utilization management with emphasis on discharge planning + Understand and ... to obtain and/or share information relating to benefits and the BCBSMA utilization management process + Collaborate with members/families, providers, medical… more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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  • Manager Utilization Management - Day…

    Penn State Health (Hershey, PA)
    …Manager Utilization Management - DAY SHIFT - Utilization Management **Location** US:PA: Hershey | Registered Nurse | Full Time **Req ID** null ... OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS...nursing required + Currently licensed to practice as a registered nurse by Pennsylvania Board of … more
    Penn State Health (11/16/24)
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  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (11/09/24)
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  • RN , Utilization Management

    Humana (Frankfort, KY)
    …and help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse ( RN ) in the… more
    Humana (11/19/24)
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  • Utilization Management Nurse

    CVS Health (Carson City, NV)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted...all noncompact states. + 1 year of varied UM ( utilization management ) experience within an inpatient/outpatient setting,… more
    CVS Health (11/29/24)
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  • Utilization Management RN

    HCA Healthcare (Campbell, CA)
    …midpoint of the range. **Introduction** Do you have the career opportunities as a(an) ** Utilization Management RN ** you want with your current employer? We ... of colleagues. Do you want to work as a(an) Utilization Management RN where your...your knowledge and expertise! **Job Summary and Qualifications** The ** Utilization Management Nurse ** 's primary… more
    HCA Healthcare (11/27/24)
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  • Director of Case Management

    Scottish Rite for Children (Dallas, TX)
    …to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - Hospital Additional ... Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention +… more
    Scottish Rite for Children (11/11/24)
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  • Utilization Management Coordinator…

    Trinity Health (Pontiac, MI)
    …customers and community groups. **D.** **Experience** Three years recent acute care utilization management experience. Knowledge of regulations relative to ... licensure within the State of Michigan. Certified Professional in Utilization Review/ Management preferred. **C** **Special Skill / Aptitudes** Understanding… more
    Trinity Health (10/09/24)
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