- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management ...involving shadowing a team member on-site on Tuesdays and remote shadowing via Teams. Pay and Benefits The pay… more
- CVS Health (Phoenix, AZ)
- …the lives of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven team that's ... Child Safety (DCS). + Knowledge of Behavioral Health Outpatient Services. + Utilization Management (UM) Experience. **Education** + Master's degree required for… 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
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Assistant **Cottingham & Butler/...will also triage the call to determine if a Utilization Review Nurse is needed to complete ... SISCO** 1 Positions ID: 4755768008 Posted On 07/01/2025 **Job Overview** ** Utilization Management Assistant** **Location** : Onsite in Dubuque, IA. Also… more
- CVS Health (Charleston, WV)
- …more compassionate. And we do it all with heart, each and every day. ** Utilization Management Clinical Consultant** ** Remote - West Virginia** Schedule is ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
- Atrius Health (Watertown, MA)
- …**Clinical Programs* **Title:** *Licensed Practical Nurse (LPN) Anticoagulation Management Service - Remote * **Location:** *Watertown MA* **Requisition ID:** ... care system in the country. *SUMMARY* Under the direction and supervision of a Nurse Leader or designee, this licensed practical nurse provides direct patient… more
- Sharecare (Columbia, SC)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Children's Hospital Boston (Boston, MA)
- …Posting Title:Per Diem RN Case Manager, Utilization Management /ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license… more
- Integra Partners (Troy, MI)
- …individual situation or the local delivery system rendering the criteria inappropriate, the Utilization Management Nurse will route the case to the ... is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a salaried, 40+ hour per week position… more
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