- 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 ... visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization Management … more
- Cognizant (Salt Lake City, UT)
- …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... 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
- 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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Salt Lake City, UT)
- …and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
- CVS Health (Salt Lake City, UT)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… 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 ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Mountain...career! We are interviewing candidates for our Operating Room Registered Nurse opening. **Apply today and a… more
- Intermountain Health (South Jordan, UT)
- …(https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/)** **Minimum Qualifications:** + Current Registered Nurse (RN) license ... + Experience working with third-party payors + Previous experience in case management , utilization review, and/or discharge planning. **If you're ready to… more
- Sharecare (Salt Lake City, UT)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- University of Utah (Salt Lake City, UT)
- …a nurse specialty from an accredited program; current licensure to practice as a Registered Nurse or as an Advance Practice Registered Nurse (APRN) ... **Open Date** 11/19/2025 **Requisition Number** PRN43626B **Job Title** PS Clinical Nurse Specialist **Working Title** PS Clinical Research Nurse **Career… more
- Molina Healthcare (Salt Lake City, UT)
- …chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * ... be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… 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, ... post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings… more
- Intermountain Health (Sandy, UT)
- …metrics, analyze trends, and ensure regulatory compliance. **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor ... + Case Management Certification + Demonstrated experience in case management , utilization review, value-based care, and/or discharge planning. + Basic… 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 ... solutions. + Conducts workflow analysis and makes recommendations for change management strategies. + Conducts quality assurance testing prior to solution deployment… more
- 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...related field. + One year of experience in a utilization review or case management environment. +… more
- Molina Healthcare (West Valley City, UT)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active...emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management … more
- Molina Healthcare (Salt Lake City, UT)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more