• Utilization Management

    CVS Health (Madison, WI)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (10/21/25)
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  • LTSS Service Coordinator - RN Clinician (RN…

    Elevance Health (Waukesha, WI)
    …an accommodation is granted as required by law._ The **LTSS Service Coordinator-RN Clinician ** is responsible for overall management of member's case within the ... and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral more
    Elevance Health (10/23/25)
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  • Care Review Clinician , PA (RN)

    Molina Healthcare (Madison, WI)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
    Molina Healthcare (10/26/25)
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  • Utilization Management Clinical…

    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 ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (10/26/25)
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