- Adecco US, Inc. (Minneapolis, MN)
- …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under...Nurse works under the direct supervision of an RN or MD. . Performs utilization review… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...care Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year… more
- CVS Health (Tallahassee, FL)
- …anywhere in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...setting required - Must have active current and unrestricted RN licensure in state of Florida - Willingness to… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- CVS Health (Baton Rouge, LA)
- …is Monday-Friday, 8AM-5PM CST with weekend/holiday coverage required (as needed). As a Utilization Management Nurse Consultant, you will utilize clinical ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience...**Required Qualifications** + 3+ years of experience as a Registered Nurse in a clinical setting. +… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental knowledge-based care to assigned clients while ... and guidelines. Responsibilities Major Duties (To include but not limited to): The Registered Nurse Utilization Management Registered Nurse … more
- Humana (Charleston, WV)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...your skills to make an impact** **Required Qualifications** + RN License without restrictions in the state of West… more
- CVS Health (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management (UM) Nurse Consultant is a remote, full-time role ... external stakeholders. The position also involves coaching healthcare staff on utilization management principles and contributing to policy development.… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse ( RN )** for a full-time position supporting the 2d Medical ... in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- AdventHealth (Tampa, FL)
- …contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... for additional review as determined by department standards. The Utilization Management Nurse is accountable...need to succeed:** + Associate's of Nursing Required + Registered Nurse ( RN ) license Required… more
- CVS Health (Annapolis, MD)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- CVS Health (Baton Rouge, LA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
- CVS Health (Madison, WI)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Harrisburg, PA)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- CVS Health (Columbus, OH)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 2+ years of ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote- WFH **Schedule** - Mon-Fri Standard… more
- US Tech Solutions (Hopewell, NJ)
- …the transition to the continuum of care. Performs duties and responsibilities assigned by management . Serves as mentor/trainer to new RN 's and other staff as ... management principles. + Requires working knowledge of operations of utilization , case and/or disease management processes. - Requires knowledge of… more
- CVS Health (Annapolis, MD)
- …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 (Boise, ID)
- …without personal distractions to meet quality and metric expectations. **Required Qualifications** + Registered Nurse ( RN ) - active license. + 3+ Years ... or initiate a Medical Director referral as needed. Assists management with training new nurse reviewers/business partners...of clinical experience. + 1+ Year of Utilization Review Management and/or Medical … more