- CVS Health (Raleigh, NC)
- …is part of the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee… more
- CVS Health (Columbus, OH)
- …Consultant role is fully remote and employee can live in any state. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible for ensuring the member is receiving the… more
- CVS Health (Harrisburg, PA)
- …live in any state. There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... make health care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- CVS Health (Harrisburg, PA)
- …Consultant role is 100% remote and the candidate can live in Pennsylvania. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... coordinate, document and communicate all aspects of the utilization /benefit management program. You would be responsible for ensuring the member is receiving the… 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 Position ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will facilitate, coordinate, and approve… more
- Humana (Columbus, OH)
- **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
- Humana (Carson City, NV)
- **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
- CVS Health (Austin, TX)
- …make health care more personal, convenient and affordable. Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical ... Qualifications + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...(twice per month) Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience… more
- Adecco US, Inc. (Dallas, TX)
- **Join Our Team as a Utilization Management Nurse !** **Experience Required:** + Five years inpatient clinical nursing experience in an acute care hospital ... setting + Minimum of two years Utilization Management acute care setting experience + Minimum of one year drafting and submitting reconsiderations and appeals to… more
- Adecco US, Inc. (Dallas, TX)
- Adecco Medical is seeking a ** Utilization Management Nurse ** for a Direct Hire position with our client in Dallas, Texas. **Experience** : + Five years ... in an acute care hospital setting required. + Minimum of two years Utilization Management acute care setting experience required. + Minimum of one year drafting… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Columbus, OH)
- …and deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+ years of… more
- Kepro (Indianapolis, IN)
- …partner for health solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team. ... Job Summary: Our Utilization Management Appeals Nurse - LPN/RN will help orchestrate the seamless resolution of appeals in line with health regulations. He… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** 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 ensuring CCA meets CMS compliance standards in… more
- Glens Falls Hospital (Glens Falls, NY)
- …who work at least 30 hours per week, can be foundhere. **Job:** **Nursing - Case Management * **Title:** *Registered Nurse - Utilization Review Nurse - ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and… more
- CVS Health (Plantation, FL)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. -Utilizes clinical experience and skills in a ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Minimal 3-5+ years… more
- CVS Health (Columbus, OH)
- …a work at home position and employee can live in any state. As a Utilization Nurse Consultant you will utilize clinical skills to coordinate, document and ... communicate all aspects of the utilization /benefit management program. You would be responsible...and is detail oriented and highly organized. The UM Nurse Consultant reviews services to assure medical necessity, applies… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+ years of ... more personal, convenient and affordable. Position Summary Duals UM Nurse Consultant Pennsylvania - Institutional Special Needs Plan (PA...in state of residence - Must have previous inpatient utilization review experience - Must be able to work… more
- ProgenyHealth (Elk Grove Village, IL)
- ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. Our program promotes appropriate utilization , ... and attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for admissions, lengths of stay and a facilitator for… more
- CVS Health (Trenton, NJ)
- …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