- HCA Healthcare (Bountiful, UT)
- …Center have the opportunity to make a real impact. As an Operating Room Registered Nurse you can be a part of change. Benefits Mountain West Surgery Center, offers a ... location. It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- VA Salt Lake City Health Care System (Salt Lake City, UT)
- …(PACT) or the clinical team within the Specialty they are supporting, to review clinic appointment availability ( utilization ) to ensure that clinic schedules are ... coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules… more
- Molina Healthcare (West Valley City, UT)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
- University of Utah (Salt Lake City, UT)
- …**Open Date** 06/18/2025 **Requisition Number** PRN42207B **Job Title** PS Clinical Nurse Specialist **Working Title** Clinical Research Nurse **Job Grade** ... Rate Range** 60000 to 90400 **Close Date** 10/12/2025 **Priority Review Date (Note - Posting may close at any...on current clinical and research information. 8. Collaborates with Nurse Manager in orientation of new employees and provides… more
- Molina Healthcare (Midvale, UT)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... _For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of...Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- CVS Health (Salt Lake City, UT)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Sharecare (Salt Lake City, UT)
- … utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- HCA Healthcare (Draper, UT)
- …from any other healthcare provider. We are seeking an Operating Room Registered Nurse to join our healthcare family. **Benefits** Lone Peak Surgery Center, offers a ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Bountiful, UT)
- …have the opportunity to make a real impact. As an Operating Room Registered Nurse you can be a part of change. **Benefits** Mountain West Surgery Center, offers ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Orem, UT)
- …satisfaction and personal growth, we encourage you to apply for our OR Registered Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an OR Registered Nurse PRN you want with your current employer? We...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- CVS Health (Salt Lake City, UT)
- …As a QM Nurse Consultant you will be responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets ... required - 2+ years of experience as a Registered Nurse - Must have active, current and unrestricted RN...5:00pm in time zone of residence **Preferred Qualifications** - Utilization Management review - Managed Care experience… more
- Prime Therapeutics (Salt Lake City, UT)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must ... drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing referral… more
- Intermountain Health (Murray, UT)
- …- Case management Certification. - and - Experience in Case management, Utilization review , and/or discharge planning. **Physical Requirements:** Ongoing need ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...Qualifications Current RN license for state in which the nurse practices. - and - Three years of clinical… more
- Humana (Salt Lake City, UT)
- …enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million ... The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director team to… more
- Molina Healthcare (West Valley City, UT)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
- Molina Healthcare (West Valley City, UT)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- Intermountain Health (Murray, UT)
- …in the Healthy Connections department leads a team supporting care management and utilization review clinical staff. This role is responsible for overseeing ... process for end users and providers in relation to the care management and utilization review systems. + Collaborates to account for any system changes which… more
- HCA Healthcare (Salt Lake City, UT)
- …+ Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. Works ... + Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. + Develop,… more
- Highmark Health (Salt Lake City, UT)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health Care ... of care activities under the direction of a registered nurse and/or social worker. + The incumbent interacts with...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
