- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Little Rock, AR)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Little Rock, AR)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- Humana (Little Rock, AR)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Little Rock, AR)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Lincoln Financial (Little Rock, AR)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- CVS Health (Little Rock, AR)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- CVS Health (Little Rock, AR)
- …members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the ... + 3+ years inpatient clinical experience as a Registered Nurse . + 3+ years of Managed Care experience. +...years of Managed Care experience. + 3+ years of Utilization Management experience. + 1+ year Leadership… more
- Sharecare (Little Rock, AR)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- CVS Health (Little Rock, AR)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- Summary The Dialysis Registered Nurse (RN) is a professional nurse with specialized knowledge and skills who demonstrates leadership when providing, directing, ... with other disciplines/departments to achieve desired patient outcomes. Functions as primary nurse for ESRD patient panel and serves as key resource assisting… more
- Evolent (Little Rock, AR)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Highmark Health (Little Rock, AR)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Evolent (Little Rock, AR)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- CVS Health (Little Rock, AR)
- …research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. Required Qualifications: ... Registered Nurse (RN) required. Working knowledge of problem solving and...all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- Catholic Health Initiatives (Little Rock, AR)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria. +… more
- Community Health Systems (Bentonville, AR)
- …place to live! **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities ... under the supervision of a Registered Nurse or physician. This role involves reviewing medical records...escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies avoidable… more
- Community Health Systems (Bentonville, AR)
- **Job Summary** The Care Manager - LPN supports effective utilization management and discharge planning by coordinating patient care activities under the ... supervision of a Registered Nurse or physician. This role involves reviewing medical records...escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies avoidable… more
- Highmark Health (Little Rock, AR)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... Documents, processes and routes requests for services to the nurse reviewer and other departments based on documentation procedures,...and management . + Route Cases Based on Established Guidelines. +… more
- Community Health Systems (Springdale, AR)
- …strong clinical or healthcare experience with a focus on hospital discharge planning, utilization management , and case management required + Previous ... knowledge of pre-acute and post-acute care resources, care transitions, and healthcare utilization management . + Proficient in data aggregation and analysis,… more