• Utilization Management Nurse

    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 #LI-REMOTE Apply… more
    WellSpan Health (05/02/25)
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  • Utilization Management Nurse

    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
    LA Care Health Plan (03/27/25)
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  • Utilization Management Nurse

    Humana (Tallahassee, FL)
    …and help us put health first** Humana Healthy Horizons in Florida is seeking a Utilization Management Nurse who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 's work assignments...Active Licensed Practical Nurse , (LPN) or Licensed Registered Nurse ( RN ) in the… more
    Humana (04/25/25)
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  • Utilization Management Nurse

    Adecco US, Inc. (Houston, TX)
    Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Management Nurse in Houston, TX! This role is hybrid with a mix of work from home ... 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Management Nurse :** . Responsible...:** * Bachelors' degree in nursing * Current, unrestricted RN License in Texas . 2 to 5 years… more
    Adecco US, Inc. (05/01/25)
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  • Utilization Management

    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
    Crouse Hospital (03/20/25)
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  • Registered Nurse Coordinator…

    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
    Trinity Health (04/02/25)
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  • Registered Nurse

    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
    Aspen Medical (04/23/25)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area + Managed Care experience preferred, especially Utilization Management + Preference for those residing… more
    CVS Health (05/02/25)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... current and unrestricted RN licensure in state of residence + 1+ year(s)...able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work… more
    CVS Health (05/02/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …other events, as directed by their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3+ years of experience ... external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set...as a Registered Nurse + 1+ years of clinical… more
    CVS Health (04/24/25)
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  • Utilization Management Nurse

    Katmai (Fort Carson, 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
    Katmai (04/20/25)
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  • Utilization Management Review…

    AmeriHealth Caritas (Dover, DE)
    …required; Bachelor's Degree in Nursing (BSN) preferred. + An active OH or compact state Registered Nurse ( RN ) license in good standing is required. + 3+ ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services,… more
    AmeriHealth Caritas (04/29/25)
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  • Utilization Management RN

    AdventHealth (Altamonte Springs, FL)
    …role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
    AdventHealth (05/03/25)
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  • Utilization Management RN

    Truman Medical Centers (Kansas City, MO)
    …Schedule** 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** ** Utilization Management Nurse (UM RN )** _Optimize Care. Improve Outcomes. Elevate ... **Please log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care… more
    Truman Medical Centers (04/16/25)
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  • SNF Utilization Management RN

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied… more
    Humana (05/03/25)
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  • Utilization Review RN (1.0 FTE)

    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
    St. Peters Health (02/15/25)
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  • Utilization Review Specialist

    Nuvance Health (Danbury, CT)
    *Description* Summary: Required- Registered Nurse ( RN ) The purpose of the Utilization Management Nurse is to support the physician, the ... and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level...Preferred- Two Years Utilization Review Experience Required- Registered Nurse ( RN ) Working… more
    Nuvance Health (04/23/25)
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  • Utilization Management RN

    Ellis Medicine (Schenectady, NY)
    Basic Function: The Utilization Management Registered Nurse (UM RN ) supports daily coordination of care across healthcare continuum with the ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
    Ellis Medicine (04/03/25)
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  • Registered Nurse Care Manager…

    McLaren Health Care (Lansing, MI)
    …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... required and directed. _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's...the Military Training network (MTN) _Preferred:_ + Experience in utilization management /case management , critical care,… more
    McLaren Health Care (04/23/25)
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  • Registered Nurse -Care Manager…

    McLaren Health Care (Petoskey, MI)
    …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... per Standard Operating Procedure (SOP). **Qualifications:** **Required** * State licensure as a Registered Nurse ( RN ) * Bachelor's degree in nursing from… more
    McLaren Health Care (04/30/25)
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