• Clinical UM Nurse 2

    CenterWell (Santa Fe, NM)
    …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
    CenterWell (06/13/25)
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  • Strategy Advancement Advisor

    Humana (Santa Fe, NM)
    …+ 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
    Humana (06/06/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Santa Fe, NM)
    …state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in ... appropriate care at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under-utilization. Assumes a leadership… more
    Molina Healthcare (06/06/25)
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