- WellSpan Health (York, PA)
- Utilization Management Nurse ( RN ) -...administration or management . Preferred Licenses: + Licensed Registered Nurse Upon Hire Required or + ... quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible... Registered Nurse Multi State License Upon Hire Required Apply Now… more
- Humana (Lexington, 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 (Dublin, OH)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...an impact** **Required Qualifications** + Bachelor's degree + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Albany, NY)
- …weeks of training will be Monday through Friday, 8:00am to 5:00pm EST. As a Utilization Management Nurse Consultant you will utilize clinical experience and ... of residence + 3+ years of experience as a Registered Nurse + 1+ year(s) of Med/Surg...to 7:00pm EST with holiday rotation per business needs. Utilization Management is a 24/7 operation and… more
- CVS Health (Montgomery, AL)
- …operation and work schedules may include weekends, holidays, and evening hours As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...of clinical experience in acute or post-acute setting + Utilization management is a 24/7 operation. Work… more
- CVS Health (Tallahassee, FL)
- …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...**Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current… more
- CVS Health (Trenton, NJ)
- …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...of residence + 3+ years of experience as a Registered Nurse working in ER, Med/Surg, and/or… more
- Actalent (Santa Barbara, CA)
- Job Title: Health Plan Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on ... Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one...patient care, and professional nursing standards of practice Skills: Utilization Management , Medi-Cal, Medicare, RN ,… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... occasional weekends (typically requires 6 weekends a year). Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works… 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...BSN or MSN degree, required * Current valid California RN license, required * Two or more years of… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent ... outcomes are achieved, and high-quality professional practice is realized. **Position Purpose:** Registered Nurse Coordinator is a dynamic leadership role that… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... Management through the American Nurses Credentialing Center or Utilization Management Accreditation through National Committee for...full, active, and unrestricted license to practice as a Registered Nurse as required in the TO… more
- Texas Health Resources (Arlington, TX)
- ** RN / Registered Nurse - Utilization Management , Clinical Reviews** **Work location:** 100% remote but must live in Texas, preferably in the Dallas-Fort ... an acute hospital setting required and + 1 Year Utilization Management required and + Experience in...of medical necessity criteria preferred **Licenses and Certifications** + RN - Registered Nurse Current… more
- 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
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- CVS Health (Harrisburg, PA)
- …Friday 8:00 am to 5:00 pm CST with rotating late evening and weekend shifts. Utilization Management is a 24/7 operation and work schedule may include weekends, ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + Must reside in… more
- Katmai (Usaf Academy, CO)
- …Nursing (BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted ... Registered Nurses ( RN ) licensed in Colorado, be...checks. **DESIRED QUALIFICATIONS &** **SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- US Tech Solutions (Columbia, SC)
- …the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and… more
- St. Peters Health (Helena, MT)
- The Utilization Management Nurse reports directly to Utilization Review RN Coordinator. The UR Nurse supports the UR RN Coordinator in ... for the organization and is responsible for ensuring complaint utilization and cost-effective care delivery. The UR Nurse...serves as a collaborative and supportive liaison and educator to providers and staff around utilization management … more