• Utilization Management Nurse

    Humana (Little Rock, AR)
    …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
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  • Telephonic Nurse Case Manager Senior

    Elevance Health (Seattle, WA)
    ** Telephonic Nurse Case Manager Senior** **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager Senior** . is responsible for care … more
    Elevance Health (09/30/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Houston, TX)
    ** Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager II** is responsible...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (09/11/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Los Angeles, CA)
    ** Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care … more
    Elevance Health (08/29/25)
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  • Telephonic Nurse Case Manager

    ICW Group (San Diego, CA)
    …assessment and evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical ... Current unrestricted Registered Nurse (RN) or Licensed Vocational Nurse (LVN) required. Certification in case management , rehabilitation nursing… more
    ICW Group (09/17/25)
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  • Utilization Management Nurse

    CVS Health (Richmond, VA)
    …And we do it all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a ... Utilization Nurse Consultant, you will utilize clinical...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
    CVS Health (09/26/25)
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  • Cost Containment Analyst

    ICW Group (Lisle, IL)
    …of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review, Telephonic Nurse Case Management , and Field Nurse ... + Acts as a gatekeeper for referrals between in-house telephonic nurse case managers, claims examiners and... management issues related to bill review, case management and utilization review. + Works closely… more
    ICW Group (09/22/25)
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  • Disease Management Nurse - Remote

    Sharecare (Providence, RI)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...for supporting the goals and objectives of the Disease Management program by providing high quality telephonic more
    Sharecare (09/13/25)
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  • Registered Nurse - Case Manager

    ERP International (Yuma, AZ)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case...the certifications below **OR** Possess a Master's Degree in Nurse Case Management from a program accredited… more
    ERP International (07/22/25)
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  • Health Plan Nurse Coordinator

    Actalent (Santa Barbara, CA)
    …efficiently to support member care plan goals. + Perform utilization management activities, which may include telephonic or onsite clinical review; case ... need is now looking for a REMOTE Health Plan Nurse Coordinator to join their team! Here you will...alpha resource center, parents helping parents, etc. knowledge of Utilization Management process/ turnaround times. + Familiar… more
    Actalent (09/19/25)
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