- Aequor (New York, NY)
- …an occupational nursing professional Minimum experience of 1-3 years in case management , utilization review and/or quality assurance Experience in episodic care, ... employees within regulated scope of practice and disability case management . Experience/Education: MS/NP in nursing degree and current NP...days onsite, then 4 days/week onsite and 1 day remote ) 8:30 AM to 4:30 PM (Monday - Friday)… more
- Saint Francis Health System (Tulsa, OK)
- Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Virtual ... click HERE to login and apply.Full Time7p - 7aVirtual Nurse works from an on-site office location (not a... works from an on-site office location (not a remote position)Will perform admit, discharge chart review and other… more
- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,… more
- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... There is no travel expected with this position. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and… more
- CVS Health (Columbus, OH)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... and external constituents in the coordination and administration of the utilization /benefit management function.Required Qualifications* 3+ years of experience… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+ years of… more
- CVS Health (Lansing, MI)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a...external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+… more
- Insight Global (New York, NY)
- …here https://www.nursys.com/LQC/LQCTerms.aspx and send to me with QB - 4-5 years of Remote Utilization Management experience at Payors, inpatient or ... Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case Management - Day (Temporary) Location: WellSpan Health, York, PA Schedule: Full Time Sign-On Bonus Eligible ... effective and quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible for screening… more
- AmeriHealth Caritas (Newark, DE)
- ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ... for UM DE, and serves as SME for clinical components DE Medicaid Utilization Management Program. Works in close collaboration with all departments to… more
- Humana (Richmond, VA)
- **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...change based on business needs + This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Montgomery, AL)
- **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...Hours are Monday-Friday 8am-5pm EST/CST + This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- University of Washington (Seattle, WA)
- Req #: 228720 Department: HARBORVIEW - UTILIZATION MANAGEMENT Posting Date: 05/03/2024 Closing Info: Open Until Filled Salary: $7375 - $13,396 per month Shift: ... benefits for this position, click here (https://hr.uw.edu/benefits/wp-content/uploads/sites/3/2018/02/benefits-summary-classified-staff-greater-than-half-time-20220908\_a11y.pdf) . RN2, Utilization Management Specialist. This is a hybrid… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse Job...hybrid position with 2 days in-office and 3 days remote . Work Environment This role is a full-time position ... and appropriate length of stay. Hard Skills + Active nurse licensure in the state of FL + Knowledge...in the state of FL + Knowledge of case management and UR concepts + Utilization review… more
- CVS Health (Bismarck, ND)
- …shift up to 8:00pm EST zone (twice per month) Position Summary Precertification: Utilization Management Nurse Consultant + Utilizes clinical experience and ... 1+ year(s) of Med/Surg experience Preferred Qualifications + Prior Authorization or Utilization Management experience + Managed care experience + MedCompass… more
- CVS Health (Baton Rouge, LA)
- …Required Qualifications + 5+ years of clinical experience + 1+ year(s) of utilization management , concurrent review and/or prior authorization experience + 5+ ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in… more
- CVS Health (Lansing, MI)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit ... to make health care more personal, convenient and affordable. Position Summary Fully remote Work from home anywhere in the US. Working hours will be Monday-Friday… more
- CVS Health (Phoenix, AZ)
- …and services both inpatient and outpatient services requiring precertification. + Utilization Management nurses use specific criteria to authorize ... care more personal, convenient and affordable. Position Summary Position Summary 100% remote position from anywhere in the US Work hours: 11:30am-8:00pm EST,… more
- CVS Health (Trenton, NJ)
- …rotation per business needs Preferred Qualifications - Prior authorization & utilization management experience - Outpatient Clinical experience - Knowledge ... internal and external constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills… more
