- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Medical... RN - Intensive Care Registered Nurse MercyOne Experienced Sales Executive - Risk Management ... **Job Overview** **Description** Medical Associates is looking for a ** Utilization Management Nurse ** to join...Featured Job TH Ad TH Comments **Similar Jobs** Clinic RN - Registered Nurse : Oncology/ Palliative… more
- Actalent (Sunrise, FL)
- Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a crucial role in optimizing the utilization of healthcare ... on department activities. Essential Skills + Clinical review + Utilization review + Utilization management ... Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License + Minimum of two years… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- CVS Health (Little Rock, AR)
- …and work schedules will include weekends, holidays, and evening hours As a Utilization Management Nurse Consultant, you will utilize clinical skills ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...to 7pm in time zone of work being supported. Utilization management is a 24/7 operation. Work… more
- Actalent (Des Moines, IA)
- Job Title: Utilization Management Nurse Job Description **Must reside in Iowa or South Dakota** The Utilization Management Nurse is responsible ... with providers to resolve utilization review issues. + Process utilization management requests using clinical knowledge and expertise. + Collaborate… more
- Actalent (Des Moines, IA)
- …metrics as established for the utilization management unit. Essential Skills + Registered Nurse ( RN ) or Licensed Practical Nurse (LPN) with ... Utilization Management Nurse - Job Description**Must reside in Iowa or South Dakota** This role involves providing members and healthcare providers with… more
- Humana (Charleston, WV)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...your skills to make an impact** **Required Qualifications** + RN License without restrictions in the state of West… more
- Humana (Louisville, KY)
- **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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Elevance Health (Morgantown, WV)
- RN Utilization Management /Review Nurse - InPatient Medicaid (JR155056) **Location:** This position requires you to **reside in the state of West ... : Monday through Friday, 8am - 5pm The **Medical Management Nurse ** (Medicaid Utilization Review)...an equivalent background. + Current active, valid and unrestricted RN license to practice as a health professional within… more
- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse ( RN ) is responsible for UM reviews for patients who receive hospital care. Responsibilities ... An UM Registered Nurse is responsible for UM reviews...accreditation standards, and performance measures. Uses emergency and bed management software and utilization data to manage… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... Management through the American Nurses Credentialing Center or Utilization Management Accreditation through National Committee for...full, active, and unrestricted license to practice as a Registered Nurse as required in the TO… more
- WellSpan Health (York, PA)
- …for leave of absence administration or management . Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... effective and quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible for screening… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with ... services, administrative officers, Emergency Department (ED) staff, and Bed Management . The nurse is responsible for applying...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Annapolis, MD)
- …active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area, + Managed Care experience preferred, especially Utilization Management , + Preference for those residing… more
- CVS Health (Raleigh, NC)
- …/benefit management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN ... Monday through Friday, 9:00am to 5:30pm EST with occasional holiday rotation. Utilization Management is a 24/7 operation and work schedules will include holidays… more
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- Actalent (Sunrise, FL)
- Utilization Management Behavioral Health ClinicianUtilization Management Behavioral Health Clinician We're seeking a dedicated Behavioral Health Clinician to ... join our Utilization Management team. In this role, you'll...nursing or behavioral health field. + Active Florida license ( RN , LCSW, LMSW, LPHA, or LMHC). + 2+ years… more
- Katmai (Fort Carson, CO)
- …Nursing (BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted ... Registered Nurses ( RN ) licensed in Colorado, be...checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN , to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more