• Coordinator Special Needs Waiver Populations,…

    CVS Health (Baton Rouge, LA)
    …it all with heart, each and every day. **Position Summary** The Utilization Management Coordinator/UMNC assists in ensuring that authorization request decisions ... children, ie generators, housing, rentals) * Collaborate with care management and utilization management teams...providers and goals are being met **Required Qualifications** * Registered Nurse (Required) * Ability to facilitate… more
    CVS Health (12/19/25)
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  • Clinical Registered Nurse

    Cognizant (Salem, OR)
    …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
    Cognizant (12/23/25)
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  • RN - Case Manager - BSN -…

    John Muir Health (Walnut Creek, CA)
    …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + BLS ... the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** +… more
    John Muir Health (12/27/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
    CenterWell (11/13/25)
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  • Utilization Management Nurse

    Katmai (Fort Carson, CO)
    …Nursing (BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted ... Registered Nurses ( RN ) licensed in Colorado, be...checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
    Katmai (12/18/25)
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  • Utilization Management Clinical Team…

    CVS Health (Columbus, OH)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
    CVS Health (12/19/25)
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  • Utilization Management RN

    Grace Hospital (Morganton, NC)
    …my patients and their families ." THE POSITION Join our dynamic healthcare team as a Utilization Management RN Weekender, where you will play a vital role in ... Blue Ridge HealthCare Hospitals - Morganton Clinical Case Management THE ORGANIZATION At UNC Health Blue Ridge,...healthcare delivery. Must have licenses to practice as a Registered Nurse in North Carolina and have… more
    Grace Hospital (12/06/25)
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  • Utilization Management Clinical…

    CVS Health (Frankfort, KY)
    …behavioral health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky ... and external constituents in the coordination and administration of the utilization /benefit management function. + Utilizes clinical skills to coordinate,… more
    CVS Health (12/31/25)
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  • RN Utilization Manager - Care…

    UNC Health Care (Smithfield, NC)
    …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management more
    UNC Health Care (12/23/25)
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  • RN Utilization Review - Case…

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... for case management scope of services including: Utilization Management services supporting medical necessity and...One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN more
    Tenet Healthcare (12/03/25)
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