- Humana (Charleston, WV)
- **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 ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC...$ 2 .00 per hour + Premium Pay + Charge Nurse - $1.50 per hour + Standby - 1/4 of ... Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem Registered Nurse II/III - Utilization Management VCMC Salary… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Utilization Management Registered...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN ... Duties (To include but not limited to): The Registered Nurse Utilization Management Registered ...1 year of professional nursing experience equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Adecco US, Inc. (Minneapolis, MN)
- …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under... 2 + years of experience in managed care, Utilization Review, Case Management or 5+ years… more
- The County of Los Angeles (Los Angeles, CA)
- …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... or Medical Service Coordinator, CCS.** -OR- OPTION II: Two ( 2 ) years of experience as a registered nurse...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...CCM (Certified Case Manager) **Required Experience (must have):** + 2 to 3 years Utilization Management… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN...clinical experience in an acute hospital setting. At least 2 years of Utilization Management /Case ... nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- CVS Health (Harrisburg, PA)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Eastern zones -BSN… more
- US Tech Solutions (Hopewell, NJ)
- …NJ or Compact State Nurse License. + Requires a minimum of two ( 2 ) years clinical experience. + Requires minimum of three (3) years' experience in the health ... office, otherwise remote Hours 8-5, 5 days a week 2 weeks of training (potentially working with a mentor... principles. + Requires working knowledge of operations of utilization , case and/or disease management processes. -… more
- CVS Health (Columbus, OH)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 2 + years ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote- WFH **Schedule** - Mon-Fri Standard… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …of the interdisciplinary team. Responsibilities Duties include but not limited to: Utilization Review (UR) Registered Nurse (RN) is responsible for providing ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN… more
- Dignity Health (Carmichael, CA)
- …or UM Certification **Knowledge to be successful in the role:** + Understand how utilization management and case management programs integrate + Knowledge of ... **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for the… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...with required occasional weekend, holiday and evening rotations. Schedule 2 : Saturday and Sunday 8am-5pm CST with flexible Weekdays… more
- CDPHP (Albany, NY)
- …care experience is required as a Registered Nurse . + Minimum of two ( 2 ) years Utilization Management experience is preferred. + Knowledge of ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...transportation, DME requests and inpatient readmissions. In collaboration with management , the UR nurse identifies potentially high-cost… more
- CVS Health (Tallahassee, FL)
- …every day. **Position Summary** **Fully remote with requirement to reside in Florida.** + Utilization Management is a 24/7 operation and the work schedule may ... in Florida + 3+ years of clinical experience + Utilization Management is a 24/7 operation and...schedule may include weekends, holidays, and evening hours. + 2 + years' experience using personal computer, keyboard navigation, navigating… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of ... Contract to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills… more
- SSM Health (MO)
- …+ Two years' registered nurse experience and three years' utilization management experience, with two years' of demonstrated progressive leadership ... Oklahoma or Wisconsin. **Job Summary:** Oversees the system wide day-to-day operational management of Utilization Management (UM) activities and services… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening ... + Req #:41910-31048 + FTE:1 + Posted:July 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- …of acute/clinical care experience. Minimum of 2 years of experience in Case/Care/ Utilization Management in an acute care or health plan setting. Minimum of ... Supervisor, Utilization Management RN Job Category: Clinical...nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get… more
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