- Integra Partners (Troy, MI)
- …experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key ... UM program. Salary: $60,000.00/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse 's responsibilities include but are not limited to: + Perform… more
- Katmai (Fort Carson, CO)
- …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 able to practice using a nurse compact state license or have a license from any United States jurisdiction (with no limitations,… more
- US Tech Solutions (Columbia, SC)
- …education with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member advocate through ... of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech Solutions:** US Tech Solutions is a… more
- CenterWell (Austin, TX)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- CVS Health (Harrisburg, PA)
- …Please replace this section with the Job Summary **Required Qualifications** Please replace this section with the Required Job Qualifications **Preferred ... Qualifications** Please replace this section with the Preferred Job Qualifications **Education** Please replace this section with the Education Requirements **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this… 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 appropriate ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management-related reviews and functions to ensure that appropriate data are… more
- McLaren Health Care (Flint, MI)
- …help people live healthier and more satisfying lives. We are looking for a Utilization Management RN, to join in leading the organization forward. MHP is a Managed ... to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to review and… more
- Community Health Systems (Naples, FL)
- Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is an ... more available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, and supporting… more
- Cognizant (Salem, OR)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience in ... to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical… more
- BJC HealthCare (St. Louis, MO)
- …of RN experience performing care for hospitalized patients + 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity + Must ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization … more