• Utilization Management Nurse

    CenterWell (Augusta, ME)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
    CenterWell (08/02/25)
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  • Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …**Position Summary** **Fully remote with requirement to reside in Florida.** + Utilization Management is a 24/7 operation and the work schedule may include ... **Required Qualifications** + Must have active, current and unrestricted RN licensure in Florida + Must reside in Florida...in Florida + 3+ years of clinical experience + Utilization Management is a 24/7 operation and… more
    CVS Health (07/30/25)
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  • Utilization Management Clinician…

    CVS Health (Sacramento, CA)
    …+ Direct clinical experience in a hospital setting or prior Utilization Management experience. + Valid California unrestricted independent professional ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program for preauthorization for mental health services.… more
    CVS Health (08/08/25)
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  • After Hours Adult Triage RN

    Atrius Health (Boston, MA)
    …system in the country. *SUMMARY * Under the direction of the Department Chief, Nurse Leader or designee, this registered professional nurse provides practice ... **Job:** **Nursing* **Organization:** **Internal Medicine* **Title:** *After Hours Adult Triage RN Evenings/Weekends/Holidays - Part Time - Remote * **Location:**… more
    Atrius Health (06/26/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Duluth, GA)
    …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... **Branch Location** : Duluth, GA **This is not a remote or work-from-home position. This position requires you to...transportation. + Two years as a Registered Nurse with at least one-year of management more
    CenterWell (06/18/25)
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  • Case Manager ( RN ) - Transitional Care…

    Stanford Health Care (Palo Alto, CA)
    …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure and/or Compact ... This is a hybrid role having a combination of remote and onsite as scheduled. Whether this would be...as scheduled. Whether this would be your first case management role or you are seasoned, here is your… more
    Stanford Health Care (08/08/25)
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  • Senior Care Manager ( RN )

    Centene Corporation (Chicago, IL)
    …IL** **Are you a passionate RN with a strong background in case management or utilization management within an inpatient setting? Join our dedicated ... 30 miles of Peoria.** **What We're Looking For:** + ** Registered Nurse ( RN ) with active...) with active Illinois license** + **Experience in case management and/or utilization review** + **Previous work… more
    Centene Corporation (08/03/25)
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  • RN Case Manager: University Hospital (Care…

    University of Michigan (Ann Arbor, MI)
    …such as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review ... RN CASE MANAGER: University Hospital (Care Management...Identify opportunities for cost reduction and participate in appropriate utilization management venues + Conducts referrals and… more
    University of Michigan (08/08/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for… more
    Centene Corporation (08/02/25)
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  • Senior LTSS Service Care Manager, RN

    Centene Corporation (Austin, TX)
    …4-6 years of related experience. Bachelor's degree in Nursing preferred **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... competitive benefits including a fresh perspective on workplace flexibility. ** Registered Nurse Case Manager needed in** **West...Med/Surg, Internal Medicine, LTC, SNF, or Nursing Rehab + RN Case Management and/or RN more
    Centene Corporation (07/31/25)
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