- CHRISTUS Health (Arp, TX)
- DescriptionSummary: The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and wellness ... other providers. Incumbent oversees integrated data warehouse including program utilization , disease management programs and contracted provider network support.… more
- CHRISTUS Health (San Antonio, TX)
- …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- CoxHealth (Branson, MO)
- …patient care team toward goal achievement in accordance with Standards of Nurse Anesthesia Practice, National Standards of Care as identified by respective ... * Job Requirements ◦ Education ▪ Required: Program completion from an accredited nurse anesthesia education program ◦ Experience ▪ Required: Minimum 1 year nursing… more
- Daiichi Sankyo, Inc. (Chesapeake, VA)
- …nurses working under the general direction of the Regional Director of Clinical Nurse Managers. The OCE is responsible for educating HCPs/clinics with infusion and ... strong, long-term relationships with clinical personnelEnsures appropriate and compliant utilization of product and disease state education as it relates… more
- CVS Health (VA)
- … Management Nurse Consultant (UMNC) position is 100% remote. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and ... communicate all aspects of the utilization /benefit management program and our plan sponsor(s). You would...use of clinical tools and information/data review, the UM Nurse Consultant reviews services to assure medical necessity, applies… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 250930-5612FP-001 Location Hartford, CT Date Opened 10/2/2025 12:00:00 AM Salary $78,480* - ... Services (DMHAS (https://portal.ct.gov/dmhas) ), is seeking to hire a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&LinkSpec=RecruitNum2&R1=&R3=) at the Blue… more
- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent ... best and most appropriate treatment, care, or services for Enrollees. The Utilization Management Nurse Lead coordinates and communicates with Providers,… more
- Emory Healthcare/Emory University (Decatur, GA)
- …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / RN)** . ... be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in...Review Department and must be an expert in the utilization review functions and able to cover any role… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services. The role… more
- UCLA Health (Los Angeles, CA)
- Description Under the direction of the Assistant Director, the ICM Medicare Advantage Utilization Review Nurse performs utilization review of medical ... population enrolled under UCLA Medical Group. The ICM Medicare Advantage Utilization Review Nurse ensures that home health and durable medical equipment services… more
- CVS Health (FL)
- …in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule...document and communicate all aspects of the utilization /benefit management program. You would be responsible for ensuring… more
- Humana (Little Rock, AR)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring ... for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as specified… more
- Justice, Bureau of Prisons/Federal Prison System (Rochester, MN)
- …of a Bureau of Prisons, Medical Referral Center (MRC). Serves as the Utilization Review Nurse and assists in quality improvement activities through data ... the appropriateness of medical care and communicates findings to the Utilization Review Committee. Applies predetermined evidence-based criteria sets and clinical… more
- Centene Corporation (New York, NY)
- …license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all ... determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a professional and… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the ... position has achieved an expert level at all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and… more
- AdventHealth (Daytona Beach, FL)
- …MEDICAL PKWY, Daytona Beach, 32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a...to resolve status disputes. The Utilization Management Nurse is accountable for a designated patient caseload and… more
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