- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Sharecare (Salt Lake City, UT)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… 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 ... management of complex patient care. The Patient Safety Manager...Executive Leadership in a format that is conducive for utilization in decision making, strategic planning and performance improvement.… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- …in workshops and training programs for career advancement. 9. Resource and Safety Management : Identify and assess resource utilization and safety issues, and ... continuing practice of other nursing staff in these areas. 6. Consult Management : Perform consult review, consult routing, and completion of consults. 7. Leadership… more
- Molina Healthcare (West Valley City, UT)
- …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… more
- CVS Health (Salt Lake City, UT)
- …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
- Lincoln Financial (Salt Lake City, UT)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
- Evolent (Salt Lake City, UT)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
- University of Utah Health (Salt Lake City, UT)
- …discharge plans prepared and delegated by social work or nurse case management by coordinating with home care agencies, post-acute care facilities, durable ... of care activities under the direction of a registered nurse and/or social worker. The incumbent interacts with representatives...related field. + One year of experience in a utilization review or case management environment. +… more
- Molina Healthcare (West Valley City, UT)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- University of Utah Health (Salt Lake City, UT)
- …are integral to our mission. EO/AA_ This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across ... the patient care continuum from pre-admission through post-discharge. Case management services include monitoring patient care to ensure progress toward desired… more
- Sharecare (Salt Lake City, UT)
- …/ 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