• Utilization Management Clinical…

    CVS Health (Frankfort, KY)
    …KENTUCKY - SEE REQUIRED QUALIFICATIONS FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...LMFT, LPAT_** **_) - OR - Active unrestricted Compact Registered Nurse ( RN ) license with… more
    CVS Health (06/06/25)
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  • Manager Utilization Management

    Tufts Medicine (Burlington, MA)
    … Review and Discharge Planning including implementation and annual review of the Utilization Management Plan and assisting with the coordination of the ... Utilization Management Committee. The ...and ensuring optimum outcomes. **Job Description** **Minimum Qualifications:** 1. Registered Nurse (BSN or higher) or other… more
    Tufts Medicine (06/01/25)
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  • Utilization Management

    Humana (Louisville, 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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
    Humana (06/10/25)
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  • Utilization Management Review…

    AmeriHealth Caritas (Washington, DC)
    …Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred. + A Registered Nurse ( RN ) license in the District of Columbia in ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services,… more
    AmeriHealth Caritas (06/03/25)
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  • Registered Nurse ( RN ) Case…

    Community Health Network (Indianapolis, IN)
    Registered Nurse ( RN ) Case...cost effectiveness through the integrating and functions of case management , utilization review and management ... North has a full-time RN Case Manager position available. The Registered Nurse Case Manager is responsible for the assessment, planning, implementation,… more
    Community Health Network (05/06/25)
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  • Registered Nurse ( RN ) Case…

    Ochsner Health (New Orleans, LA)
    …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
    Ochsner Health (04/30/25)
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  • RN - Registered Nurse

    Trinity Health (Mishawaka, IN)
    …care. This is NOT a remote position.** **_About the job:_** The licensed Registered Nurse ( RN ) plans & provides professional nursing services & standards ... in one of the following: Certified Acute Care Virtual Registered Nurse (CAVRN), Acute/critical care nursing (CCRN),...Nurse (CEN), Cardiac Medicine (CMC), Certified Med Surg RN (CMSRN), Certified Neuroscience RN (CNRN), Certified… more
    Trinity Health (06/06/25)
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  • Registered Nurse ( RN ), Care…

    Beth Israel Lahey Health (Wakefield, MA)
    …considered in lieu of degree + Active, unrestricted Massachusetts Registered Nurse License required. Certification in Case Management (CCM) preferred. NH ... to the BILHPN provider's risk populations. The Care Manager, RN provides care management services to the...behavior. Working with the healthcare team, the Care Manager, RN monitors appropriate utilization of healthcare resources,… more
    Beth Israel Lahey Health (05/30/25)
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  • Registered Nurse RN Case…

    Banner Health (Gilbert, AZ)
    …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... be the opportunity you've been waiting for. As an RN Case Manager, you will contribute your expertise and...regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained… more
    Banner Health (05/30/25)
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  • RN - Registered Nurse

    Geisinger (Danville, PA)
    …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... Job Summary Please note this is NOT a remote position. Geisinger is proud to offer an Virtual ICU RN a $41 minimum hiring rate with increased rates for… more
    Geisinger (05/10/25)
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  • Clinical Registered Nurse

    Sharecare (Springfield, IL)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare… more
    Sharecare (05/10/25)
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  • Case Manager - Registered Nurse

    CVS Health (Atlanta, GA)
    …Must be able to obtain multi state Registered Nurse ( RN ) licensures **Preferred Qualifications** + Case Management Certification + Transplant experience ... and every day. **Position Summary** This Case Manager - Registered Nurse ( RN ) position is...blended role doing both Case Management and Utilization Management . The RN Case… more
    CVS Health (05/31/25)
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  • Registered Nurse - Call Center,…

    SSM Health (St. Louis, MO)
    …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... Integrated Health Technologies **Worker Type:** Regular **Job Highlights:** Note:** Remote work is not available until after two years,...Registered Nurse ( RN ) - Missouri Division of Professional… more
    SSM Health (06/12/25)
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  • Registered Nurse , Telehealth…

    ChenMed (Jacksonville, FL)
    …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... Triage assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
    ChenMed (06/05/25)
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  • Registered Nurse , Telehealth,…

    ChenMed (Deerfield Beach, FL)
    …expanding and we need great people to join our team. The Part Time Registered Nurse , Virtual Care, is responsible for providing telephonic emergency triage and ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
    ChenMed (05/20/25)
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  • Registered Nurse ( RN

    Bon Secours Mercy Health (Greenville, SC)
    …are recognized for clinical and operational excellence. **This position will work remote , following an initial on-site training period (approx. 90 days). The work ... on information provided by the patient, and documenting the assessment, utilizing the nurse triage algorithms. Assists with the evaluation and review of all incoming… more
    Bon Secours Mercy Health (06/14/25)
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  • Registered Nurse - Outpatient Staff…

    Veterans Affairs, Veterans Health Administration (Cheyenne, WY)
    Summary The Outpatient Staff Registered Nurse ( RN ) is responsible for providing competent, evidence-based outpatient care to assigned patients with oversight ... discharge, and supporting factors that impact customer satisfaction. Responsibilities The Outpatient Staff Registered Nurse ( RN ) will assist in directing the… more
    Veterans Affairs, Veterans Health Administration (06/14/25)
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  • Registered Nurse - Radiology…

    Veterans Affairs, Veterans Health Administration (Durham, NC)
    …The Durham VA Healthcare System is seeking (1) highly skilled/experienced Registered Nurse to serve within Radiology. Demonstrates leadership, ... experience/ingenious approaches to management of complex patient care. Accountable for the ...is achieved & a safe therapeutic environment. Responsibilities The Registered Nurse for Durham Radiology will be… more
    Veterans Affairs, Veterans Health Administration (06/06/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Frankfort, KY)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
    CVS Health (06/01/25)
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  • Ops Registered Nurse

    MyFlorida (Tallahassee, FL)
    OPS REGISTERED NURSE - 64937233 Date: Jun...is supervised by a School Health Nursing Director. Case Management Provide in-person and remote case ... . Requisition No: 854396 Agency: Department of Health Working Title: OPS REGISTERED NURSE - 64937233 Pay Plan: Health Care Practice Position… more
    MyFlorida (06/07/25)
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