- CVS Health (Austin, TX)
- …is part of the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- CVS Health (Phoenix, AZ)
- …occasionally per the need of the department.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the… more
- CVS Health (Tallahassee, FL)
- …may include weekends and holidays and evening rotations. This is a full-time remote Utilization Management Nurse Consultant opportunity. As a Utilization ... health care more personal, convenient and affordable. **Position Summary** Utilization management is a 24/7 operation. Work...residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute… more
- 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 ... and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- 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 Position ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
- CVS Health (Columbus, OH)
- …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant, you will utilize clinical skills ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Jefferson City, MO)
- …members sign up to work one major and one minor holiday yearly. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... health care more personal, convenient and affordable. **Position Summary:** Utilization Management is a 24/7 operation and...Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN… more
- Elevance Health (Washington, DC)
- The Utilization Management Nurse is responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member ... and minimum of 2 years acute care clinical experience. + Minimum 1 year Utilization Management experience preferred. For candidates working in person or remotely… more
- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... their appropriate admission status. This individual will support the Utilization Management process by maintaining effective and...+ Required: + Currently licensed as a Registered Professional Nurse in New York State. + Associates Degree +… more
- UCLA Health (Los Angeles, CA)
- Description As the Utilization Management & Quality Review Nurse , you will be responsible for: + Ensuring appropriate, cost-effective, and high-quality care ... for New Century Health Plan members + Conducting utilization management (UM) activities in accordance with health plan policies and regulatory guidelines +… more
- CVS Health (Columbus, OH)
- …and affordable. **Primary Job Duties & Responsibilities** + Drives effective utilization management practices by ensuring appropriate and cost-effective ... use of healthcare resources. + Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare… more
- 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 ... be licensed in all noncompact states. + 1 year of varied UM ( utilization management ) experience within an inpatient/outpatient setting, concurrent review or… more
- CVS Health (Raleigh, NC)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** Utilization Management is a 24/7 operation and work schedules may ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...experience with Microsoft Office applications (Outlook, Teams, Excel) + Utilization Management is a 24/7 operation and… more
- CVS Health (Columbus, OH)
- …convenient and affordable. **Position Summary** **This is a fulltime remote Utilization Management opportunity.** **The schedule is Monday through Friday, ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and… more
- CVS Health (Columbus, OH)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** Utilization Management is a 24/7 operation and work schedule may ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** -3+ years of ... preference for those residing in EST or CST. _Utilization Management is a 24/7 operation and work schedule may...experience as a Registered Nurse -Must hold active and unrestricted RN licensure in… more
- CVS Health (Montgomery, AL)
- …Must possess 1+ years of clinical experience in acute or post acute setting - Utilization management is a 24/7 operation. Work schedules will include a minimum ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- Katmai (Usaf Academy, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... licensed in Colorado, be able to practice using a nurse compact state license or have a license from...checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- CVS Health (Jefferson City, MO)
- …and external constituents in the coordination and administration of the utilization /benefit management function. - Typical office working environment with ... to promote quality effectiveness of Healthcare Services and benefit utilization - Consults and lends expertise to other internal...Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN… more