- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a diligent and detail-oriented Post Review Nurse to perform timely ... and quality of our healthcare services. Responsibilities + Conduct utilization management reviews and claims assessments using...CPT coding systems. Work Environment This role is fully remote , allowing you the flexibility to work from a… more
- University of Washington (Seattle, WA)
- …Description** **UW Medical Center - Montlake** has an outstanding opportunity for **a Utilization Management Nurse .** **POSITION HIGHLIGHTS** The goal of the ... ** Utilization Management (UM) Nurse ** is to ensure delivery...**WORK SCHEDULE** + 100% FTE + Mondays-Friday, Days + Remote **PRIMARY JOB RESPONSIBILITIES** + Identify clinical indications for… more
- CVS Health (Lansing, MI)
- …include weekends, holidays, and evening hours._ _Weekends: F/S/S/M 10 hour shifts_ **UM Nurse Consultant** Fully Remote - WFH **Position Summary** UM Nurse ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… more
- CVS Health (Baton Rouge, LA)
- …is Monday-Friday, 8AM-5PM CST with weekend/holiday coverage required (as needed). As a Utilization Management Nurse Consultant, you will utilize clinical ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Utilizes clinical experience...Qualifications** + 3+ years of experience as a Registered Nurse in a clinical setting. + Must have active… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Nurse 2 RN utilizes clinical nursing skills to support ... enhanced licensure, (eNLC) without disciplinary action + 1+ year previous experience in utilization management + 2+ years prior clinical experience preferably in… more
- CVS Health (Columbus, OH)
- …operation and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote - WFH **Schedule** - Mon-Fri Standard work ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** 2+ years of… more
- US Tech Solutions (Hopewell, NJ)
- … management principles. + Requires working knowledge of operations of utilization , case and/or disease management processes. - Requires knowledge of ... PTO ideally First and Last day in office, otherwise remote Hours 8-5, 5 days a week 2 weeks...requirements. + Requires mentoring knowledge on the operations of utilization /case/disease management . **Education:** + Requires an associate… more
- CVS Health (Charleston, WV)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- CVS Health (Salt Lake City, UT)
- …procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to ... Occasional Overtime may be required. This position will be remote working from home anywhere in the US. **Position...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...holidays, and evening hours._ This will be a full-time remote role. Schedule 1: Monday through Friday, 8am to… more