- CVS Health (Santa Fe, NM)
- …members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- Actalent (Santa Barbara, CA)
- … Coordinator - REMOTE POSITION Non-profit healthcare network is looking for a utilization management registered nurse to join their team on a contract ... 3-month contract + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU: + Remote...a leading healthcare organization Job Description The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse … more
- CVS Health (Lansing, MI)
- …And we do it all with heart, each and every day. ** Utilization Management Nurse Consultant** Fully Remote - WFH **Position Summary** Utilizes clinical ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… more
- CVS Health (Lansing, MI)
- …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant - Oncology and Transplant ... may vary based on business needs) **Location** : 100% Remote (US only) **Position Summary** American Health Holding, Inc....a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... EST Hours; Shift times may vary based on business needs) Location: 100% Remote (US only) **About Us** American Health Holding, Inc. (AHH), a division of… more
- CVS Health (Little Rock, AR)
- …healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position Summary** The Team Lead plays a ... EST Hours; Shift times may vary based on business needs) Location: 100% Remote (US only) **About Us** American Health Holding, Inc. (AHH), a division of… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and ... most appropriate treatment, care, or services for Enrollees. The Utilization Management Nurse Lead coordinates...or compliance. **Additional Information** + **Workstyle:** This is a remote position. + **Travel:** Up to 25% travel to… more
- Humana (Boise, ID)
- …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- Humana (Frankfort, KY)
- **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
- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a diligent and detail-oriented Post Review Nurse to perform timely ... and quality of our healthcare services. Responsibilities + Conduct utilization management reviews and claims assessments using...CPT coding systems. Work Environment This role is fully remote , allowing you the flexibility to work from a… more
- University of Washington (Seattle, WA)
- …Description** **UW Medical Center - Montlake** has an outstanding opportunity for **a Utilization Management Nurse .** **POSITION HIGHLIGHTS** The goal of the ... ** Utilization Management (UM) Nurse ** is to ensure delivery...**WORK SCHEDULE** + 100% FTE + Mondays-Friday, Days + Remote **PRIMARY JOB RESPONSIBILITIES** + Identify clinical indications for… more
- CVS Health (Lansing, MI)
- …include weekends, holidays, and evening hours._ _Weekends: F/S/S/M 10 hour shifts_ **UM Nurse Consultant** Fully Remote - WFH **Position Summary** UM Nurse ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… 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...Qualifications** + 3+ years of experience as a Registered Nurse in a clinical setting. + Must have active… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Nurse 2 RN utilizes clinical nursing skills to support ... enhanced licensure, (eNLC) without disciplinary action + 1+ year previous experience in utilization management + 2+ years prior clinical experience preferably in… more
- CVS Health (Columbus, OH)
- …operation and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote - WFH **Schedule** - Mon-Fri Standard work ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 2+ years of… more
- US Tech Solutions (Hopewell, NJ)
- … management principles. + Requires working knowledge of operations of utilization , case and/or disease management processes. - Requires knowledge of ... PTO ideally First and Last day in office, otherwise remote Hours 8-5, 5 days a week 2 weeks...requirements. + Requires mentoring knowledge on the operations of utilization /case/disease management . **Education:** + Requires an associate… more
- CVS Health (Charleston, WV)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- CVS Health (Salt Lake City, UT)
- …procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to ... Occasional Overtime may be required. This position will be remote working from home anywhere in the US. **Position...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...holidays, and evening hours._ This will be a full-time remote role. Schedule 1: Monday through Friday, 8am to… more