- Cognizant (Salt Lake City, UT)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Salt Lake City, UT)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... to UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as… more
- CVS Health (Salt Lake City, UT)
- …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Patient Safety Manager- Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to ... during non-administrative tours. Other Duties as assigned. Preferred Experience: Master's Prepared Registered Nurse 5 years of Patient Safety Experience an/or… more
- CVS Health (Salt Lake City, UT)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Telehealth protocols, guidelines, and workflows. Evaluate patient feedback and clinical outcomes to recommend improvements to Telehealth services. Stay up-to-date… more
- HCA Healthcare (Kaysville, UT)
- …may vary based on center needs** **We are hiring a Temporary Operating Room Registered Nurse for a seasonal commitment to help meet staffing demands during ... colleagues. Do you want to work as a(an) OR Registered Nurse - Seasonal where your passion...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Humana (Salt Lake City, UT)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Sharecare (Salt Lake City, UT)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Lincoln Financial (Salt Lake City, UT)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... 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… more
- Molina Healthcare (West Valley City, UT)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- Molina Healthcare (Salt Lake City, UT)
- …for denial or modification of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and ... of Nursing **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or… more
- Molina Healthcare (Salt Lake City, UT)
- …* Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse (RN). License must be active and unrestricted ... least 3 years management/leadership experience in a clinical leadership, clinical systems and/or informatics, utilization management, or care management… more
- Molina Healthcare (West Valley City, UT)
- …behavioral health, or equivalent combination of relevant education and experience. + Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed ... **Required Qualifications** + At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of… more
- Molina Healthcare (Salt Lake City, UT)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- University of Utah Health (Salt Lake City, UT)
- …and supporting coordination of care activities under the direction of a registered nurse and/or social worker. The incumbent interacts with representatives ... discharge plans prepared and delegated by social work or nurse case management by coordinating with home care agencies,...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
- University of Utah Health (Salt Lake City, UT)
- …for clinical practice in the State of Utah. + **Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire ... that are integral to our mission. EO/AA_ + This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes… more
- Molina Healthcare (West Valley City, UT)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- University of Utah Health (Salt Lake City, UT)
- …chart in electronic medical record. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days ... + Collaborates with Primary Care Physicians and Advanced Practitioners to implement clinical interventions for all MCS patients throughout their care continuum. +… more