- US Tech Solutions, Inc. (Columbia, SC)
- …. Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits ... Job Title: Licensed Practical Nurse Location: Columbia SC 29229 Duration: 3+ Months.... Monday-Friday 8:30-5pm. CONTRACT ONLY . Microsoft Teams interview. Remote after 1 Week onsite training. . PREFERRED/NICE TO… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team… more
- Saint Francis Health System (Tulsa, OK)
- Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Virtual ... click HERE to login and apply.Full Time7p - 7aVirtual Nurse works from an on-site office location (not a... works from an on-site office location (not a remote position)Will perform admit, discharge chart review and other… more
- Cambia Health Solutions, Inc (Renton, WA)
- …behavioral health care management ); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management )#LI- Remote ... health care experience.Are you an RN who has experience with utilization and care management ? Do you enjoy conducting needs analysis to identify and recommend… more
- ProgenyHealth (Elk Grove Village, IL)
- ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. Our program promotes appropriate utilization , ... attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for...events throughout the year + Role specific - full remote work week ProgenyHealth positively recruits people from diverse… more
- Commonwealth Care Alliance (Boston, MA)
- **Why This Role is Important to Us:** 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 ensuring CCA meets CMS compliance standards in… more
- CVS Health (Raleigh, NC)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any state. ... the dedicated team supporting the membership of plan sponsor. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,… more
- CVS Health (Columbus, OH)
- …convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the … more
- CVS Health (Columbus, OH)
- …convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in ... any state. No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all… more
- CVS Health (Austin, TX)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state.As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the … more
- CVS Health (Columbus, OH)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... and external constituents in the coordination and administration of the utilization /benefit management function.Required Qualifications* 3+ years of experience… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+ years of… more
- CVS Health (Trenton, NJ)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a...external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+… more
- Trinity Health (Columbus, OH)
- …and facilitates problem resolution. + Knowledge of the functional operations of utilization management , care coordination and transitions of care. + Proven ... own in Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** The Utilization Review Nurse ensures that authorization requests and provider or… more
- Insight Global (New York, NY)
- …here https://www.nursys.com/LQC/LQCTerms.aspx and send to me with QB - 4-5 years of Remote Utilization Management experience at Payors, inpatient or ... Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case Management - Day (Temporary) Location: WellSpan Health, York, PA Schedule: Full Time Sign-On Bonus Eligible ... 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 (Vancouver, WA)
- …a small-town charm, this is the place to call home. The VISN 20 Utilization Management Nurse Specialist collaborates with interdisciplinary team members, ... (UM) Programs in VISN 20. The VISN 20 Utilization Management Nurse Specialist works...to 4:30pm PST Compressed/Flexible: Not available Telework: Not available Remote /Virtual: This is not a virtual or remote… more
- Humana (Austin, TX)
- **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 (Baton Rouge, LA)
- …Required Qualifications + 5+ years of clinical experience + 1+ year(s) of utilization management , concurrent review and/or prior authorization experience + 5+ ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience and skills in… more
- CVS Health (High Point, NC)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... solutions to make health care more personal, convenient and affordable. Fully remote . Position Summary + Utilizes clinical experience and skills in a collaborative… more
