• Clinical Registered Nurse

    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
    Cognizant (11/15/25)
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  • Utilization Management Nurse - Home…

    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
    Humana (09/12/25)
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  • Utilization Review Nurse

    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
    University of Utah Health (10/02/25)
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  • Utilization Management Nurse

    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
    Humana (11/16/25)
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  • Utilization Management Nurse

    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 ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
    Humana (11/18/25)
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  • SNF Utilization Management RN - Compact Rqd

    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
    Humana (09/12/25)
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  • Operating Room Registered Nurse

    HCA Healthcare (Bountiful, UT)
    …you passionate about delivering patient-centered care?** Submit your application for Operating Room Registered Nurse position and spend more time at the bedside ... shape business and operational outcomes, or work to deliver clinical excellence behind the scenes in data science, case...career! We are interviewing candidates for our Operating Room Registered Nurse opening. **Apply today and a… more
    HCA Healthcare (11/19/25)
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  • PS Clinical Research Nurse

    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
    University of Utah (11/19/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Layton, 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
    Molina Healthcare (11/14/25)
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  • Disease Management Nurse - Remote

    Sharecare (Salt Lake City, UT)
    …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
    Sharecare (10/22/25)
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  • Nursing Quality Informatics Nurse - HMHI

    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
    University of Utah Health (11/05/25)
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  • Product Portfolio Clinical Administrator

    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 (11/14/25)
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  • Heart Failure Clinical Coordinator

    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 (11/18/25)
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  • Care Review Clinician, PA (RN)

    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
    Molina Healthcare (10/18/25)
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  • RN Case Manager

    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
    University of Utah Health (10/28/25)
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  • Care Review Clinician (RN)

    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 Summary Provides 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
    Molina Healthcare (11/13/25)
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  • Case Management Assistant

    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 care agencies,...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
    University of Utah Health (11/17/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Salt Lake City, UT)
    clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
    Datavant (11/12/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Layton, UT)
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
    Molina Healthcare (11/01/25)
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  • Program Manager, Healthcare Services (Contract…

    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 the… more
    Molina Healthcare (11/13/25)
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