- CVS Health (Carson City, NV)
- …cardiology **Preferred Qualifications** -1+ years' experience in either Precertification or Utilization Review -1+ years' experience Managed Care -Strong ... And we do it all with heart, each and every day. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is fully remote but must reside in… more
- UCLA Health (Los Angeles, CA)
- …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... 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 coordinators and… more
- AmeriHealth Caritas (Washington, DC)
- …(BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department (ED), ... reviews within a managed care organization preferred **Licensure** + Active and unencumbered Registered Nurse license in the District of Columbia + Valid and… more
- Intermountain Health (Las Vegas, NV)
- …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice ... Care Management I leads and collaborates with care management operations across utilization review , acute and emergency department care, and ambulatory/community… more
- 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 ... every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in...OR Minimum of an Associate's in Nursing or Diploma RN for Registered Nurses **Anticipated Weekly Hours**… more
- Waystar (Atlanta, GA)
- …end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer...Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure) + 8+ years of clinical experience in… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... accreditation standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft Office… more
- Sanford Health (Rapid City, SD)
- …preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and...Nursing and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains… more
- Prime Healthcare (Inglewood, CA)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Preferred: 1. Not Applicable. Licenses and Certifications Required: 1. NJ State Professional Registered Nurse License. 2. Advance Practice Nurse License. 3. ... **The Per Diem Advanced Practice Nurse (APN) or Physician Assistant (PA) for the...(APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating… more