- Cognizant (Salt Lake City, UT)
- …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
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative ... qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization … more
- Humana (Salt Lake City, UT)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... to UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as… more
- Humana (Salt Lake City, UT)
- **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
- CVS Health (Salt Lake City, UT)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Patient Safety Manager- Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to ... during non-administrative tours. Other Duties as assigned. Preferred Experience: Master's Prepared Registered Nurse 5 years of Patient Safety Experience an/or… more
- Humana (Salt Lake City, UT)
- **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
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 11/19/2025 **Requisition Number** PRN43626B **Job Title** PS Clinical Nurse Specialist **Working Title** PS Clinical Research Nurse ... qualifications required of employees assigned to the job. The Clinical Nurse Specialist makes decisions independently and...an accredited program; current licensure to practice as a Registered Nurse or as an Advance Practice… more
- Molina Healthcare (West Valley City, UT)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support...hearings as may be required. * Serves as a clinical resource for utilization management, chief medical… more
- Intermountain Health (Murray, UT)
- **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical thinking skills to develop and implement a plan of care that provides cost ... in area(s) of responsibility. Completes documentation as required. Performs utilization review activities to provide patient appropriate, timely, and...nurse practices. - and - Three years of clinical nursing experience. - and - RNs hired or… more
- CVS Health (Salt Lake City, UT)
- …a member's overall wellness through integration. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and ... functions as well as smooth transition to programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and… more
- Molina Healthcare (Salt Lake City, UT)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- University of Utah Health (Salt Lake City, UT)
- …working with electronic health records. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... outcomes. **Responsibilities** + Facilitates the integration of data, information and clinical knowledge to support patient care decision making. + Translates and… more
- Intermountain Health (Sandy, UT)
- …metrics, analyze trends, and ensure regulatory compliance. **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor ... delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role… more
- Deloitte (Salt Lake City, UT)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- University of Utah Health (Salt Lake City, UT)
- …(Master's degree preferred) **Qualifications (Preferred)** **Preferred** + Licensure as a registered nurse strongly preferred + Management experience + ... for cost savings related to product standardization and improved product utilization by appropriately assisting in the selection, evaluation, monitoring, analysis… more
- University of Utah Health (Salt Lake City, UT)
- …is to be obtained within 30 days of hire. + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire ... providers regarding patient progress, symptoms and complications. + Participates in clinical pathway development and utilization . + Contacts insurance companies… more
- University of Utah Health (Salt Lake City, UT)
- …visits. **Licenses Required** + **One of the following** + **Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days ... that are integral to our mission. EO/AA_ + This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes… more
- Molina Healthcare (West Valley City, UT)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more