• Utilization Management Nurse

    CVS Health (Tallahassee, FL)
    …it all with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days ... other events, as directed by their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3+ years of experience… more
    CVS Health (04/24/25)
    - Related Jobs
  • RN , Utilization Review Flexi

    Chesapeake Regional Healthcare (Chesapeake, VA)
    * Remote in Hampton Roads* Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and ... resources as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of… more
    Chesapeake Regional Healthcare (02/16/25)
    - Related Jobs
  • Registered Nurse ( RN ) Case…

    Ochsner Health (New Orleans, LA)
    …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
    Ochsner Health (04/30/25)
    - Related Jobs
  • Registered Nurse RN Case…

    Banner Health (Greeley, CO)
    …the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in ... RN Case Manager, your work will be primarily remote with in clinic rounding every other month in...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more
    Banner Health (05/01/25)
    - Related Jobs
  • Registered Nurse ( RN )…

    Prometheus Federal Services (Glendale, CO)
    Registered Nurse ( RN ) -... consults / requests for completeness and appropriateness / utilization review . + Dispositioning care in the ... to federal health agencies, has an opening for multiple Registered Nurses. This position will perform administrative functions for...community per utilization review and guidelines. + Clinical review of… more
    Prometheus Federal Services (03/29/25)
    - Related Jobs
  • Registered Nurse ( RN

    Bon Secours Mercy Health (Greenville, SC)
    …utilizing the nurse triage algorithms. Assists with the evaluation and review of all incoming ambulatory oncology referrals and may be asked to assist ... are recognized for clinical and operational excellence. **This position will work remote , following an initial on-site training period (approx. 90 days). The work… more
    Bon Secours Mercy Health (03/15/25)
    - Related Jobs
  • Pre-Authorization Registered Nurse

    Humana (Atlanta, GA)
    …supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for appropriate ... or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on… more
    Humana (04/30/25)
    - Related Jobs
  • Utilization Management RN

    AdventHealth (Altamonte Springs, FL)
    … **The role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
    AdventHealth (05/03/25)
    - Related Jobs
  • Registered Nurse I (Virtual)…

    Saint Francis Health System (Tulsa, OK)
    …to patient rooms \#RNSIND 3 - 12 hour shifts days/evenings Job Summary: The Registered Nurse I (Virtual) assesses, plans, implements and evaluates nursing care, ... works from an on-site office location (not a remote position) Will perform admit, discharge chart review...Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 5… more
    Saint Francis Health System (05/01/25)
    - Related Jobs
  • Case Manager, registered Nurse

    CVS Health (Denver, CO)
    …- Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
    CVS Health (04/30/25)
    - Related Jobs