• Utilization Management Nurse

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,...Compact State Licensure Required and + RN-BC - Case Management Nurse Preferred Children's is the very… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse

    Omaha Children's Hospital (Omaha, NE)
    …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... variety of settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative, flexible, risk taker. **Licenses and… more
    Omaha Children's Hospital (09/05/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Lincoln, NE)
    …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
    CVS Health (10/18/25)
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  • Transplant Care Nurse - Remote

    Highmark Health (Lincoln, NE)
    …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... be obtained within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
    Highmark Health (10/10/25)
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  • Care Management Coordinator

    Highmark Health (Lincoln, NE)
    …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
    Highmark Health (10/16/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Grand Island, NE)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
    Molina Healthcare (10/18/25)
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  • Program Manager, Healthcare Services - Clinical…

    Molina Healthcare (NE)
    …more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent combination ... work of external vendors. + Focuses on process improvement, organizational change management , program management and other processes relative to business needs.… more
    Molina Healthcare (10/10/25)
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