- 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
- CVS Health (Workman, MN)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- 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
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency in… more
- Centene Corporation (Phoenix, AZ)
- … issues related to member care, provider interactions, and facilitates operations within utilization management . + Oversees the behavioral health (BH) ... and ensures compliance with applicable guidelines + Reviews and analyzes BH utilization management (UM) activities, over/under utilization , operations,… more
- CVS Health (Frankfort, KY)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate, ... document and communicate all aspects of the utilization /benefit management program. **Required Qualifications** + Must reside in Kentucky or bordering Counties +… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- Centene Corporation (Raleigh, NC)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... POTENTIAL FOR WEEKEND AND HOLIDAY ROTATIONS**'** MUST HOLD NORTH CAROLINA BEHAVIORAL HEALTH LICENSURE **Position Purpose:** Performs a clinical review and assesses… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site...Valley Hospital (CVH), Blue Hills Campus + UNIT : Utilization Management Unit + ADDRESS : 500 ... Services (DMHAS (https://portal.ct.gov/dmhas) ), is seeking to hire a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&LinkSpec=RecruitNum2&R1=&R3=) at the Blue… more
- Molina Healthcare (Los Angeles, CA)
- …healthcare services professionals in some or all of the following functions: care management , utilization management , behavioral health, care ... * Assists in implementing health management , care management , utilization management , behavioral...in good standing. **Preferred Qualifications** * LVN (Licensed vocational nurse ) or RN (Registered Nurse ) . License… more
- McLaren Health Care (Flint, MI)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …excellence. **_**Part Time**_** **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse (RN) functions as a care ... patient outcomes are met. + Participates in the safe management of the milieu, intervening effectively with patients who...(1) year of professional experience practicing as a Registered Nurse (RN) + Recent Behavioral Health experience… more
- CVS Health (OH)
- …and every day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Saint Francis Health System (Muskogee, OK)
- …**to login and apply.** Full Time Nights **Registered Nurse Fulltime Senior Behavioral ** Adult patients with ... may qualify for** Sign on bonus Relocation Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the nursing… more
- Molina Healthcare (GA)
- …healthcare services professionals in some or all of the following functions: care management , utilization management , behavioral health, care ... or more of the following areas: utilization management , care management , care transitions, behavioral...experience. * At least 1 year of health care management /leadership experience. * Registered Nurse (RN), Licensed… more
- Truman Medical Centers (Kansas City, MO)
- …time **Work Schedule** 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** ** Utilization Management Nurse (UM RN)** _Optimize Care. Improve Outcomes. ... log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care Continuity -… more
- Saint Francis Health System (Tulsa, OK)
- …by the department; limited benefit offerings. Variable Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related experience. Knowledge,… more
- Molina Healthcare (GA)
- …services professionals in some or all of the following functions: utilization management , care management , behavioral health and other programs. Leads ... management , care transitions, long-term supports and services (LTSS), behavioral health, nurse advice line, and/or other...or more of the following areas: utilization management , care management , care transitions, behavioral… more
- Actalent (Santa Barbara, CA)
- Remote Utilization Management RN Leading healthcare facility that aims to improve the health and wellness of those in need is now looking for a REMOTE Health ... Plan Nurse Coordinator to join their team! Here you will...alpha resource center, parents helping parents, etc. knowledge of Utilization Management process/ turnaround times. + Familiar… more