- 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)
- **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
- 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
- CVS Health (Little Rock, AR)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... hours available with Holiday,Weekend,and laterotations. + **Required Qualifications** + Registered Nurse + Must have active current and unrestricted RN licensure in… 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
- CVS Health (Little Rock, AR)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… 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
- Veterans Affairs, Veterans Health Administration (North Little Rock, AR)
- Summary The Intensive Community Mental Health Recovery (ICMHR) Registered Nurse (RN) is responsible for providing competent, evidence-based care to patients. They ... orientation, competencies and providing quality improvement and enhance outcomes utilization . Responsibilities The ICMHR program provides clinical community-based case… more
- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- Summary The individual selected for the Post Anesthesia Care Unit (PACU) Assistant Nurse Manager (ANM) position will function under the supervision of the Nurse ... nursing activities for the designated area to include patient care, utilization of personnel, scheduling, orientation and staff development. Executes position… more
- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- Summary The Emergency Department Registered Nurse (RN) will serve as a staff nurse who evaluates clinical practice and initiates change based on current concepts ... and quality improvement processes. Responsibilities Duties and responsibilities of the Registered Nurse include, but are not limited to the following: They delegate… more
- Centene Corporation (Little Rock, AR)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… 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
- 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
- CVS Health (Little Rock, AR)
- …Tuesday 6:30am to 5pm in their respective time zone.** As a Care Management Associate you will be supporting comprehensive coordination of medical services including ... supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.… more
- Sharecare (Little Rock, AR)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more