- VitalCore Health Strategies (Hopkinton, MA)
- …Insurance Employee Assistance Program and Discount Center 401K EEO Keywords: Utilization Management , RN, Nurse , Administrative, #INDMA Compensation ... in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the Regional Office...an accredited School of Nursing Licensure as a Registered Nurse in the state of employment with 1+ years… more
- VitalCore Health Strategies (Nashville, TN)
- …MINIMUM REQUIREMENTS Bachelor's degree in healthcare administration/related field. Licensed Registered Nurse . Minimum of two (2) years of management experience ... Health Care has an opening for a Health Services Administrator / Registered Nurse at Davidson County Downtown Detention Facility in Nashville, TN!! This position… more
- VitalCore Health Strategies (Ogden, UT)
- …MINIMUM REQUIREMENTS Bachelor's degree in healthcare administration/related field. Licensed Registered Nurse . Minimum of two (2) years of management experience ... Health Care, has an opening for a Health Services Administrator / Registered Nurse at Weber County Correctional Facility in Ogden, Utah! This position will be… more
- University Health (San Antonio, TX)
- …years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- University Health (San Antonio, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... services needed to be rendered. This position requires assertive clinical acumen and communication skills for serving in the...hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice… more
- VitalCore Health Strategies (Munising, MI)
- … quality and integrity of patient medical care including oversight of utilization and quality management , credentialing, and best practice guideline development ... required to 3 sites: Alger, Baraga and Newberry. This position is half clinical and half administrative. At VitalCore we pride ourselves on retaining and acquiring… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH FTE: 1.00 Full Time Shift: Days ... appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including census review,… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …and facilitate communication, problem solving, decision-making, crisis intervention, resource utilization , and conflict management * ACCOUNTABILITY - Supervise ... assignments, call in staff, send staff home and monitor attendance. Provide clinical leadership for nursing and technician staff. Ensure adequate staff to meet… more
- CVS Health (Madison, WI)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Cognizant (Salem, OR)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical … more
- Humana (Jackson, MS)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- Alameda Health System (San Leandro, CA)
- Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination ... information in the identified fields in EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review, membership… more
- CVS Health (Austin, TX)
- …9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and ... 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)
- …travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and ... with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant...to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical … more
- Houston Methodist (Houston, TX)
- …of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of… more
- Katmai (Fort Carson, CO)
- …American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the CMHS.… more
- CVS Health (Tallahassee, FL)
- …must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate ... internal and external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information and… more
- McLaren Health Care (Port Huron, MI)
- …with an acute care hospital **Preferred:** ⦁ Experience in utilization management /case management , critical care, clinical documentation, or patient ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… 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 ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...Experience Required: At least 5 years of varied RN clinical experience in an acute hospital setting. At least… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- **12/2/2025 - REVISED FTE *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / ... utilization and controlling costs./**/ *Assessment:* * Collects, reviews, and documents clinical data relevant to utilization management , including… more
