• Utilization Review Nurse

    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
    Actalent (07/16/25)
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  • Utilization Management Clinical…

    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
    CVS Health (07/13/25)
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  • Utilization Management Nurse

    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
    US Tech Solutions (07/03/25)
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  • Utilization Management Review…

    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
    AmeriHealth Caritas (06/03/25)
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  • Utilization Management Assistant

    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
    Access Dubuque (07/19/25)
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  • Utilization Management Clinical…

    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
    CVS Health (07/12/25)
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  • Licensed Practical Nurse (LPN)…

    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
    Atrius Health (05/22/25)
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  • Disease Management Nurse

    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
    Sharecare (07/12/25)
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  • Per Diem RN Case Manager, Utilization

    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
    Children's Hospital Boston (06/16/25)
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  • Utilization Review Medical Director

    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
    Integra Partners (06/07/25)
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