- Nuvance Health (Danbury, CT)
- …(2nd week) ; rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary ... of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level medical necessity reviews by… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print...Board of Registered Nursing. + A current Basic Life Support (BLS) for Healthcare Providers (CPR & AED) Program ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually Location… more
- Ventura County (Ventura, CA)
- Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem ... Registered Nurse II/III - Utilization Management VCMC Salary...is mandatory. + Must possess a valid Basic Life Support (BLS/CPR) Certificate PRIOR to the first day of… more
- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- …satisfaction throughout the continuum of care. Responsibilities The Community Care (CC) Utilization Review Registered Nurse (RN) is responsible for collecting, ... evaluates the effectiveness of the Veteran's care. Serves to support delivery of high quality, timely care to the...reviewing and care coordination for the VAHCS. The CC Utilization Review RN performs a wide variety of clinical… 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 ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, Barksdale ... needed for patterns, trends, orincidents of under or over utilization of hospital resources incidental to medical careprovided to...Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six… more
- Humana (Charleston, WV)
- …community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be...experience. + The UR RN Preceptor facilitates efforts to support compliance and adherence to standard work, policies and… more
- CVS Health (Tallahassee, FL)
- …in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and… 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 Position Type: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… more
- CVS Health (Madison, WI)
- …time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects of ... the utilization /benefit management program. Applies critical thinking and knowledge in...urgent or emergent interventions (such as triage / crisis support ). + Coordinates/Communicates with providers and other parties to… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-Site Recruitment # 250715-5612FP-001 Location New Haven, CT Date Opened 7/22/2025 12:00:00 AM Salary $78,480 - ... + + + + Introduction Are you a Registered Nurse looking for an opportunity to make a difference...planning; + Complete continuous audits/tracers of inpatient documentation in support of Joint Commission standards; and + Attend treatment… more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for the ... authorization or provides clinical guidance to Payer Communications staff to support communication with the insurance providers to obtain admission and continued… more
- CVS Health (Baton Rouge, LA)
- …in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a collaborative… more
- AdventHealth (Tampa, FL)
- …other diseases. **The role you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical ... Whole Person Wellbeing Resources + Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about...for additional review as determined by department standards. The Utilization Management Nurse is accountable for a… more
- AmeriHealth Caritas (LA)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon to: +...Degree in Nursing (BSN) preferred. + An active Registered Nurse (RN) license in good standing is required. +… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... + Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. +… more
- US Tech Solutions (Chicago, IL)
- …Medicare). + Independently coordinates the clinical resolution with internal/external clinician support as required. + Processes and evaluates complex data and ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST… more
- LifePoint Health (Louisburg, NC)
- …job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* **Requisition ... Registered Nurse (RN) Utilization Review Job Type:...Preferred Drag Edit Delete *Required Skills* * Basic Life Support (BLS) * Licenses: RN * Requires critical thinking… more
- US Tech Solutions (Columbia, SC)
- …to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral ... experience and /or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals. + Team: Fast paced, Interactive team works… more