- CVS Health (Harrisburg, PA)
- …Degree and Independently licensed Behavioral Health Clinician Or Associate Degree and Licensed Registered Nurse with Psychiatric Experience** + **3 or more years ... BH clinical Experience** + **1 or more years Utilization Management Experience** + **Work at Home...of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- Intermountain Health (Las Vegas, NV)
- …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice ... including social work and complex care planning, transitions of care, and utilization management . The position ensures compliance with state, national, and… more
- Hartford HealthCare (Willimantic, CT)
- …**Windham Hospital* **Title:** * Registered Nurse Case Manager ( RN ) - Utilization Management * **Location:** *Connecticut-Willimantic-Windham Community ... the direction of the Manager of Continuing Care and Utilization Management and in collaboration with physicians,... experience preferred. *LICENSURE/CERTIFICATION* * Current license as a registered nurse in the State of Connecticut.… more
- AnMed Health (Anderson, SC)
- …here. This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These ... necessity review, continued stay/concurrent review, retrospective review, bed status management , resource utilization management , regulatory compliance,… more
- Humana (Jackson, MS)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Austin, TX)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
- CVS Health (Austin, TX)
- …more compassionate. And we do it all with heart, each and every day. Utilization Management - Infertility Precertification unit **Position Summary** This is a ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...experience with Microsoft Office applications (Outlook, Teams, Excel) + Utilization Management is a 24/7 operation and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to help us transform healthcare? Bring your true colors to blue. The RoleThe RN Utilization Management Reviewer is responsible for facilitating care for ... benefit to provide the best quality care. The TeamThe RN Utilization Management Reviewer is...+ Licensure in additional states a plus. + For registered nurses only: a bachelor's degree in (BSN) preferred.… more