- 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
- 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)
- …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation… 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
- CVS Health (Salt Lake City, UT)
- …+ 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
- HCA Healthcare (Kaysville, UT)
- …may vary based on center needs** **We are hiring a Temporary Operating Room Registered Nurse for a seasonal commitment to help meet staffing demands during ... colleagues. Do you want to work as a(an) OR Registered Nurse - Seasonal where your passion...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… 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
- Molina Healthcare (Layton, UT)
- …and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities....or modification of payment decisions. * Serves as a clinical resource for utilization management, chief medical… more
- Lincoln Financial (Salt Lake City, UT)
- …**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
- Molina Healthcare (Layton, UT)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary... Practitioner will be required to work primarily in non- clinical settings and provide medical care to all levels… more
- Molina Healthcare (Layton, 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
- Molina Healthcare (Layton, UT)
- …for denial or modification of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and ... of Nursing **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or… more
- Molina Healthcare (Layton, UT)
- …* Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse (RN). License must be active and unrestricted ... least 3 years management/leadership experience in a clinical leadership, clinical systems and/or informatics, utilization management, or care management… more
- Molina Healthcare (Layton, UT)
- …behavioral health, or equivalent combination of relevant education and experience. + Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed ... **Required Qualifications** + At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of… more
- Molina Healthcare (Layton, 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
- University of Utah Health (Salt Lake City, UT)
- …for clinical practice in the State of Utah. + **Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire ... 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 (Layton, UT)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- HCA Healthcare (Bountiful, UT)
- …advance the agenda of unparalleled patient service. What qualifications you will need: + Registered Nurse + BSN preferred + 2+ years hospital case management or ... supporting a balance of optimal care and appropriate resource utilization . What you will do in this role: +...3+ years of clinical nursing experience + Certification in case management, nursing,… more