- University of Utah Health (Salt Lake City, UT)
- …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- Molina Healthcare (Salt Lake City, UT)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
- Molina Healthcare (Orem, UT)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- …other nursing staff in these areas. 6. Consult Management: Perform consult review , consult routing, and completion of consults. 7. Leadership and Improvement ... career advancement. 9. Resource and Safety Management: Identify and assess resource utilization and safety issues, and take appropriate actions to address them. 10.… more
- University of Utah (Salt Lake City, UT)
- …**Open Date** 06/18/2025 **Requisition Number** PRN42207B **Job Title** PS Clinical Nurse Specialist **Working Title** Clinical Research Nurse **Job Grade** ... Rate Range** 60000 to 90400 **Close Date** 10/12/2025 **Priority Review Date (Note - Posting may close at any...on current clinical and research information. 8. Collaborates with Nurse Manager in orientation of new employees and provides… more
- CVS Health (Salt Lake City, UT)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Sharecare (Salt Lake City, UT)
- … utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- Intermountain Health (Murray, UT)
- …needs in area(s) of responsibility. Completes documentation as required. Performs utilization review activities to provide patient appropriate, timely, and ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...management Certification. - and - Experience in Case management, Utilization review , and/or discharge planning. **Physical Requirements:**… more
- Intermountain Health (St. George, UT)
- …needs in area(s) of responsibility. Completes documentation as required. + Performs utilization review activities to provide patient appropriate, timely, and ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...+ Case management Certification. + Experience in Case management, Utilization review , and/or discharge planning. **Physical Requirements:**… more
- HCA Healthcare (Bountiful, UT)
- …have the opportunity to make a real impact. As an Operating Room Registered Nurse you can be a part of change. **Benefits** Mountain West Surgery Center, offers ... location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Salt Lake City, UT)
- …from any other healthcare provider. We are seeking an Operating Room Registered Nurse to join our healthcare family. **Benefits** Mt. Olympus Surgery Center, offers ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Bountiful, UT)
- …about delivering patient-centered care?** Submit your application for Operating Room Registered Nurse position and spend more time at the bedside with the patient. ... Summary and Qualifications** We are seeking an Operating Room Nurse for our ambulatory surgery center who demonstrates the...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… 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...Qualifications Current RN license for state in which the nurse practices. - and - Three years of clinical… more
- CVS Health (Salt Lake City, UT)
- …Assessment of members through the use of clinical tools and information/data review , conducts comprehensive evaluation of member's needs and benefit plan eligibility ... while assessing benefits and/or member's needs to enable appropriate utilization of services and/or administration and integration with available internal/external… more
- Molina Healthcare (UT)
- …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... For this position we are seeking a (RN) Registered Nurse who be licensed in the state they reside....are looking for a RN Supervisor to manage a utilization management team supporting 14 Marketplace plans. Home office… more
- Molina Healthcare (Salt Lake City, UT)
- …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- HCA Healthcare (Salt Lake City, UT)
- …+ Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. Works ... + Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation Improvement. + Develop,… more
- Highmark Health (Salt Lake City, UT)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- University of Utah Health (Salt Lake City, UT)
- …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health Care ... of care activities under the direction of a registered nurse and/or social worker. + The incumbent interacts with...+ Documents activities and progress in medical charts, computer billing/ utilization systems, or in other ways as directed. +… more
- Intermountain Health (Logan, UT)
- …needs in area(s) of responsibility. Completes documentation as required. + Performs utilization review activities to provide patient appropriate, timely, and ... **Job Description:** The nurse care manager works collaboratively with physicians and...+ Case management Certification. + Experience in Case management, Utilization review , and/or discharge planning. **Physical Requirements:**… more