- Adecco US, Inc. (Minneapolis, MN)
- …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under...Nurse works under the direct supervision of an RN or MD. . Performs utilization review… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...care Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year… 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 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Cottingham &... Management Cottingham & Butler/ SISCO Acute Care RN - Medical Surgical Registered Nurse ... 1 Positions ID: 4627707008 Posted On 07/01/2025 **Job Overview** ** Utilization Management Nurse ** **Location** :...20250818 Featured Job TH Ad TH Comments **Similar Jobs** Registered Nurse ( RN ) Senior Care… 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...**Required Qualifications** + 3+ years of experience as a Registered Nurse in a clinical setting. +… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental knowledge-based care to assigned clients while ... and guidelines. Responsibilities Major Duties (To include but not limited to): The Registered Nurse Utilization Management Registered Nurse … more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- Summary The Nurse II Utilization Management (UM) Registered Nurse ( RN ) is responsible for providing competent, evidence-based practices within ... level degree in Nursing may have opportunity to become registered as a nurse with a state...responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse ( RN )** for a full-time position supporting the 2d Medical ... in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , 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… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- Summary The Registered Nurse Quality & Patient Safety Nurse Manager - Utilization Management functions as a clinical expert and is responsible and ... qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: 1-3 years Utilization Management , Nurse Case Manager/Caseworker,… more
- CVS Health (Dover, DE)
- …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... current and unrestricted RN licensure in state of residence + 1+ year(s)...able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work… more
- CVS Health (Harrisburg, PA)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- CVS Health (Austin, TX)
- …/benefit management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN ... with occasional holiday rotation. **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience + Experience… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...record Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year… more
- US Tech Solutions (Hopewell, NJ)
- …the transition to the continuum of care. Performs duties and responsibilities assigned by management . Serves as mentor/trainer to new RN 's and other staff as ... management principles. + Requires working knowledge of operations of utilization , case and/or disease management processes. - Requires knowledge of… more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- Actalent (San Antonio, TX)
- …to assist each other and complete cases. Qualifications: + 2+ years of utilization management , concurrent review, prior authorization, utilization review, ... case management , and discharge planning is must + Active RN Compact License in the state of Texas is Must If you are Interested , Kindly give a call : ### Pay… more
- Veterans Affairs, Veterans Health Administration (Biloxi, MS)
- Summary The Utilization Management RN is a...level degree in Nursing may have opportunity to become registered as a nurse with a state licensing ... the Chief of Radiology or their designee. Responsibilities The Utilization Management RN serves a...assigned VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases,… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN , to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
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