- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...general and specialized principles, practices, techniques and methods of utilization review / management , discharge planning or… more
- Katmai (Fort Carson, CO)
- **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE eligible beneficiaries within the ... standards for appropriate utilization of services. Perform utilization management / review for medical necessity...within the last four (4) years as a registered nurse in utilization management . +… more
- Veterans Affairs, Veterans Health Administration (Salt Lake City, UT)
- Summary The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative ... standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Master's prepared Registered Nurse . 5 years Utilization Management … more
- CVS Health (Austin, TX)
- …role is 100% remote and the candidate can live in any state. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, ... with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant...goals and expectations. **Preferred Qualifications:** + 1+ years' experience Utilization Review experience + 1+ years' experience… more
- McLaren Health Care (Port Huron, MI)
- **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- McLaren Health Care (Bay City, MI)
- **Department:** Utilization Management **Shift:** Days **Daily Work Times:** 8am - 4:30pm **Scheduled Hours per Pay:** 40 Position Summary: Responsible for ... as Assigned: 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Position Summary** As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... of the team and business needs. **Preferred Qualifications** - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - Strong… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring ... the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
- Brighton Health Plan Solutions, LLC (NC)
- …Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with ... pace and changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more