- Health eCareers (Tempe, AZ)
- …a Utilization Review Clinician / Clinical Review Nurse to support the Behavioral Health Utilization Management (BH UM) team for AZCH . This position ... Job Title: Utilization Review Clinician / Clinical Review Nurse...final rule requirements effective January 2026. Responsibilities * Perform utilization review of behavioral health services (prior… more
- Geisinger (Wilkes-Barre, PA)
- Job Title: RN - Experienced Registered Nurse (Geisinger Wyoming Valley, Wilkes Barre)Location: Wilkes-Barre, PennsylvaniaJob Category: Inpatient RN - ... represent typical elements considered necessary to successfully perform the job.The Registered Nurse assesses plans, organizes, performs, and evaluates nursing… more
- Geisinger (Wilkes-Barre, PA)
- Job Title: LPN- Experienced Inpatient Licensed Practical Nurse (Geisinger Wyoming Valley, Wilkes Barre)Location: Wilkes-Barre, PennsylvaniaJob Category: LPN - ... Licensed Practical Nurse , Nursing and Nursing SupportSchedule: Rotation Work Type: Full...and Nursing SupportSchedule: Rotation Work Type: Full timeDepartment: Talent Management Nursing & Nursing Support TeamDate Posted: 05/09/2025Job ID:… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- Centene Corporation (Phoenix, AZ)
- … issues related to member care, provider interactions, and facilitates operations within utilization management . + Oversees the behavioral health (BH) ... compliance with applicable guidelines + Reviews and analyzes BH utilization management (UM) activities, over/under utilization...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
- CVS Health (Salt Lake City, UT)
- …to other internal and external constituents in the coordination and administration of the utilization /benefit management functions. + Must be able to talk on the ... following or equivalent:(LPC, LPCC, LMHCS, LMHC, LMFT, LCSW) OR RN with 3+ years of clinical behavioral ...of mental health and substance abuse disorders + Managed care/ utilization review experience + Crisis intervention skills + Position… more
- Omaha Children's Hospital (Omaha, NE)
- …management . + Should be a creative, flexible, risk taker. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area...Licensure Required and + RN -BC - Case Management Nurse … more
- Molina Healthcare (GA)
- …experience. * At least 1 year of health care management /leadership experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), Licensed ... in some or all of the following functions: care management , utilization management , behavioral...Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Los Angeles, CA)
- …healthcare services professionals in some or all of the following functions: care management , utilization management , behavioral health, care ... * Assists in implementing health management , care management , utilization management , behavioral...Qualifications** * LVN (Licensed vocational nurse ) or RN ( Registered Nurse ) . License… more
- CVS Health (Santa Fe, NM)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
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