- CenterWell (Providence, RI)
- …part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- Humana (Providence, RI)
- …+ Registered nurse (RN) with unrestricted licensed **OR** independent licensed clinical social worker + 2 -5 yrs of previous senior leadership experience ... and help us put health first** The Utilization Management ( UM ) Director, Clinical Strategy and Practice for...to work effectively in a cross-functional, matrixed environment. + 2 + yrs Payer experience with responsibility for the creation… more
- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Manager Utilization Management, the Nurse Utilization Management ( UM ) Reviewer is responsible for day-to-day timely clinical and service ... with Standard Operating Procedures + Ensures accurate documentation of clinical decisions and works with UM Manager...Utilization Management experience in a managed care setting + 2 or more years working in a clinical… more
- Humana (Providence, RI)
- …+ Registered nurse (RN) with unrestricted licensed **OR** independent licensed clinical social worker + 5+ years of previous clinical experience in ... Establish standardized protocols and workflows across the enterprise. + Lead activities regarding UM annual evaluation + Lead activities related to UM Program… more