- 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
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative ... qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization … more
- 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
- 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
- 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 (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
- CVS Health (Salt Lake City, UT)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- 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
- CVS Health (Salt Lake City, UT)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Intermountain Health (South Jordan, UT)
- …(https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/)** **Minimum Qualifications:** + Current Registered Nurse (RN) license ... **Job Description:** The RN Home Services Case Manager utilizes clinical expertise and critical thinking skills to direct resource... expertise and critical thinking skills to direct resource utilization to develop and implement a plan of care… more
- 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
- 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
- Molina Healthcare (Salt Lake City, 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
- 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
- Molina Healthcare (Salt Lake City, UT)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- 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
- Intermountain Health (Sandy, UT)
- …metrics, analyze trends, and ensure regulatory compliance. **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor ... delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role… more
- Deloitte (Salt Lake City, UT)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- 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 (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