- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Utilization Managment** for a full-time position supporting **Medical Managment** in ... may include but are not limited to** : Provides Utilization Management activities and functions by using...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- Corewell Health (Southfield, MI)
- …working in an organization of size and complexity comparable to Corewell Health. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required ... Together, we are Corewell Health. Scope of work The Clinical Utilization Management (UM) Supervisor is responsible for monitoring, supervising, and performing… more
- Sharp HealthCare (San Diego, CA)
- …Nursing; Accredited Case Manager (ACM) - American Case Management Association (ACMA); 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
- Centene Corporation (Columbia, SC)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... including a fresh perspective on workplace flexibility. + Collaborates with utilization management team to resolve complex care member issues + Maintains… more
- Centene Corporation (Sacramento, CA)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... Clinical Review team to ensure appropriate care to members. Manages utilization management issues related to member care, provider interactions, and facilitates… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …annual bonus eligibility, and more! **Responsibilities** **Job Summary / Purpose** The Utilization Management (UM) Director is responsible for the market(s) ... development, implementation, evaluation and direction of the Utilization Management Program and staff in support...**Required Licensure and Certifications:** Current unrestricted licensure as a Registered Nurse in the state of Washington… more
- McLaren Health Care (Detroit, MI)
- …and implementing process improvement projects as needed. _Required:_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... **Department: Utilization Management ** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible… more
- Universal Health Services (Sacramento, CA)
- Responsibilities Sierra Vista Hospital is seeking a full-time Utilization Management Coordinator (MSW, MFT, MA, RN ) for the Utilization Management ... emotional, behavioral and addiction problems. The Utilization Management Coordinator (MSW, MFT, MA, RN ) is...Utilization Management Coordinator (MSW, MFT, MA, RN ) is responsible for the managing, reviewing, and monitoring… more
- CVS Health (Raleigh, NC)
- …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. This Utilization Management (UM) Nurse Consultant...Required Qualifications - Must have active current and unrestricted RN licensure in state of residence - 2+ years… more
- CVS Health (Raleigh, NC)
- …1 holiday per year). There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant...management function. Required Qualifications: - Must be an RN with active current and unrestricted RN … more
- LA Care Health Plan (Los Angeles, CA)
- Supervisor, Utilization Management RN (Outpatient) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... to achieve that purpose. Job Summary The Supervisor of Utilization Management (UM) RN is...player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- CVS Health (Harrisburg, PA)
- …live in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant...Required Qualifications: - Must have active, current and unrestricted RN licensure in state of residence - 3+ years… more
- CVS Health (Harrisburg, PA)
- …Consultant role is 100% remote and the candidate can live in Pennsylvania. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible for ensuring the member is receiving the… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Admissions Liaison 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 (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Corewell Health (Grand Rapids, MI)
- …Health. Scope of Work Manages and coordinates the clinical functions of the Utilization Management Department. Oversees the efficiency and effectiveness of the ... utilization management teams, made up of utilization management specialists and insurance coordinators. Oversees and supports clinical team functioning… more
- Universal Health Services (San Antonio, TX)
- Responsibilities Position Summary : The Utilization Management Supervisor is responsible for planning, organizing, and managing daily operations of the ... Utilization Management team. The Supervisor duties include...Utilization Management team. The Supervisor duties include but are not...Education: + High School Diploma or GED + LVN, RN , LPC, LMSW or Bachelors Degree in Health Care… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** The Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Universal Health Services (Colorado Springs, CO)
- …WILL CONTINUE UNTIL THE POSITION IS FILLED. We have a Full Time Utilization Management Care Coordinator opportunity available, this position reports to the ... Director of Utilization Management . Schedules vary. About the Position:...registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a… 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 ... 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
- Cedars-Sinai (Los Angeles, CA)
- …Motions, Eye/Hand/Foot Coordination **Req ID** : 1261 **Working Title** : Registered Nurse - Utilization Management - 8 Hour Days **Department** : ... an accredited nursing program Bachelor's Degree Nursing preferred **Licenses:** RN State License Basic Life Support (BLS) **Experience:** 3... Utilization Management **Business Entity** : Cedars-Sinai Medical Center **Job Category**… more