- Cognizant (Concord, NH)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Concord, NH)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Fresenius Medical Center (Lowell, MA)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- CVS Health (Concord, NH)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Concord, NH)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Lincoln Financial (Concord, NH)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… more
- WellSense (Manchester, NH)
- …background check + Current unrestricted, applicable, state license to practice as a Registered Nurse + Regular and reliable transportation and the ability to ... Clinical Care Manager WellSense Health Plan is a...and community resources, with a goal of promoting appropriate utilization of services at the appropriate level and site… more
- HCA Healthcare (Derry, NH)
- …compact state Registered Nurse license + Two or more years of clinical experience. + Case Management, Utilization & Managed Care experience and 1 or more ... care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care,...supporting a balance of optimal care and appropriate resource utilization . + The RN Case Manager Team Lead will… more
- Molina Healthcare (Lowell, MA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... Job Summary The Care Review Clinician, IP Provides support for clinical member services review assessment processes. Responsible for verifying that services… more