- 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 ... visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization Management … more
- Cognizant (Salt Lake City, UT)
- …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... 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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... management of complex patient care. The Patient Safety Manager...tours. Other Duties as assigned. Preferred Experience: Master's Prepared Registered Nurse 5 years of Patient Safety… more
- Intermountain Health (Murray, UT)
- …Case management Certification. - and - Experience in Case management , Utilization review, and/or discharge planning. **Physical Requirements:** Ongoing need ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...in area(s) of responsibility. Completes documentation as required. Performs utilization review activities to provide patient appropriate, timely, and… more
- University of Utah (Salt Lake City, UT)
- …a nurse specialty from an accredited program; current licensure to practice as a Registered Nurse or as an Advance Practice Registered Nurse (APRN) ... **Open Date** 11/19/2025 **Requisition Number** PRN43626B **Job Title** PS Clinical Nurse Specialist **Working Title** PS Clinical Research Nurse **Career… more
- Molina Healthcare (Orem, UT)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… 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, ... post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings… more
- Intermountain Health (Sandy, UT)
- …metrics, analyze trends, and ensure regulatory compliance. **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor ... + Case Management Certification + Demonstrated experience in case management , utilization review, value-based care, and/or discharge planning. + Basic… 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 ... solutions. + Conducts workflow analysis and makes recommendations for change management strategies. + Conducts quality assurance testing prior to solution deployment… more
- University of Utah Health (Salt Lake City, UT)
- …and supporting coordination of care activities under the direction of a registered nurse and/or social worker. The incumbent interacts with representatives ... discharge plans prepared and delegated by social work or nurse case management by coordinating with home...related field. + One year of experience in a utilization review or case management environment. +… more
- Molina Healthcare (Orem, UT)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Datavant (Salt Lake City, UT)
- …job function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… 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
- Intermountain Health (Murray, UT)
- …Requirements:** **Qualifications** Minimum Qualifications + Current license to practice as a Registered Nurse in the state of residence. If primary state ... in care management /navigation or closely related field including Utilization Management , discharge planning, managed care, health promotion, health… 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 ... integral to our mission. EO/AA_ + This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across… more
- Molina Healthcare (Orem, UT)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... external vendors. * Focuses on process improvement, organizational change management , program management and other processes relative...combination of relevant education and experience. * Registered Nurse (RN), Licensed Vocational … more