• Utilization Management Nurse

    Humana (San Juan, PR)
    **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
    Humana (11/16/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    Humana (San Juan, PR)
    **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
    Humana (11/18/25)
    - Save Job - Related Jobs - Block Source
  • Disease Management Nurse - Remote

    Sharecare (San Juan, PR)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (10/22/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Reviewer, Nurse

    Evolent (San Juan, PR)
    …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
    Evolent (11/20/25)
    - Save Job - Related Jobs - Block Source
  • Denials Prevention Specialist, Clinician PRN

    Datavant (San Juan, PR)
    …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... 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 versed in… more
    Datavant (11/12/25)
    - Save Job - Related Jobs - Block Source