- CVS Health (Harrisburg, PA)
- …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
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- 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...as aligned to license which includes 3 years prior management experience + Current active unrestricted RN … more
- CVS Health (Baton Rouge, LA)
- …we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for Prior Authorization conducts ... in quality improvement, policy review, and education related to utilization management . * Serve as a clinical...and data integrity **Required Qualifications** * Active, unrestricted Louisiana RN license or compact license * Minimum 3 years… more
- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management to a team of UM ... a self-motivated, detail-oriented, service-driven leader with: + Current unrestricted RN licensure in CA required + Bachelors of Science,...(BSN) degree required + Five or more years of utilization management required + Four or more… more
- CVS Health (Baton Rouge, LA)
- …And we do it all with heart, each and every day. **Position Summary** The Utilization Management Nurse Consultant (UMNC) for NICU Concurrent Review conducts ... review, and education related to NICU and special populations utilization management . * Serve as a clinical...detail and data integrity **Required Qualifications** * Active, unrestricted RN license in Louisiana or a compact license. *… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
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