• Utilization Management Nurse

    CVS Health (Springfield, IL)
    …+ **M** anaged care experience + Discharge planning experience + Utilization Management experience **Education** ASN Required, BSN Preferred **Anticipated ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in… more
    CVS Health (10/08/25)
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  • RN Utilization Management - Acute…

    Trinity Health (Albany, NY)
    …in Albany, NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) per diem. The team is willing to ... Type:** Part time **Shift:** Day Shift **Description:** **RN for Utilization Management - Per Diem** **St. Peter's...grow into this wonderful opportunity to progress in their nursing career. We at St. Peter's Health Partners recognize… more
    Trinity Health (10/07/25)
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  • SNF Utilization Management RN…

    Humana (Lincoln, NE)
    …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    Omaha Children's Hospital (Omaha, NE)
    …employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case Management ... a wide variety of settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative, flexible, risk taker. **Licenses and… more
    Omaha Children's Hospital (09/05/25)
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  • Manager Utilization Management

    Intermountain Health (Las Vegas, NV)
    …including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and ... Management I leads and collaborates with care management operations across utilization review, acute and...a market or region, working collaboratively with medical staff, nursing , clinical, and revenue cycle leaders to optimize patient… more
    Intermountain Health (10/14/25)
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  • Manager of Utilization Management II

    Elevance Health (Washington, DC)
    …each week. The office is located at 609 H. Street NE.** The **Manager of Utilization Management ** **ll** is responsible for managing a team of physical health ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...+ Assists and provides back up coverage to Case Management team **Minimum Requirements:** + BA/BS in Nursing more
    Elevance Health (10/16/25)
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  • RN Utilization Management Reviewer

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …Conduct pre-certification, concurrent, and retrospective reviews with emphasis on utilization management , discharge planning, care coordination, clinical ... and gender affirming health, preferred. + 2-3 years of Utilization Management experience. + Active licensure in...+ For Registered Nurses Only: A bachelor's degree in nursing (BSN) is preferred. #LI-Hybrid Minimum Education Requirements: High… more
    Blue Cross Blue Shield of Massachusetts (09/19/25)
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  • ED Utilization Management Registered…

    AdventHealth (Tampa, FL)
    …or designated leader for additional review as determined by department standards. The Utilization Management Nurse is accountable for a designated patient ... **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse ...Preferred. 3 years experience. 3 years acute care clinical nursing experience. 2 Utilization Management more
    AdventHealth (10/11/25)
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  • Registered Nurse - Utilization

    Veterans Affairs, Veterans Health Administration (Iowa City, IA)
    Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the position. Uses UM ... and continued stay criteria and best clinical documentation and utilization management practices to ensure efficient resource...requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse more
    Veterans Affairs, Veterans Health Administration (10/16/25)
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  • Utilization Management Nurse

    Integra Partners (Troy, MI)
    The Utilization Management (UM) Nurse ...Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team ... Nurse license EXPERIENCE: + Minimum 3 years of nursing experience in acute, outpatient, or managed care setting....or managed care setting. + Minimum 2 years of utilization management experience in a payer or… more
    Integra Partners (10/16/25)
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