• Utilization Management Nurse

    CVS Health (Austin, TX)
    …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed...(LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant… more
    CVS Health (12/14/25)
    - Related Jobs
  • Medical Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and nationally...* Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state… more
    Brighton Health Plan Solutions, LLC (12/04/25)
    - Related Jobs
  • Utilization Management Nurse

    Actalent (Minnetonka, MN)
    Utilization Management Nurse Job...+ Proficiency in prior authorization processes. + Active, unrestricted RN license in the state of MN or WI. ... Description As a Utilization Management Nurse for Post Acute care, you will be responsible...necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review.… more
    Actalent (12/09/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
    CVS Health (12/13/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management more
    CVS Health (12/14/25)
    - Related Jobs
  • Utilization Management Nurse

    Saint Francis Health System (OK)
    …in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details ... Nursing. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2 years of… more
    Saint Francis Health System (12/13/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Lansing, MI)
    … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
    CVS Health (12/03/25)
    - Related Jobs
  • Utilization Management

    Katmai (Fort Carson, CO)
    …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
    Katmai (11/26/25)
    - Related Jobs
  • Registered Nurse ( RN

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Manager Utilization Management , 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… more
    Commonwealth Care Alliance (10/02/25)
    - Related Jobs
  • Registered Nurse

    ERP International (Vandenberg AFB, CA)
    **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Utilization Management ** for a temporary contract position in support ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (12/13/25)
    - Related Jobs