• Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (06/13/25)
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  • Utilization Management Nurse

    CVS Health (Raleigh, NC)
    …all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation. **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience + Experience… more
    CVS Health (06/23/25)
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  • Utilization Management Nurse

    CVS Health (Raleigh, NC)
    …holidays and evening hours._ **Must reside in CST or EST zone.** As a Utilization Management Nurse Consultant you will utilizes clinical experience and ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...Requirement to reside in EST or CST zone. + Utilization Management is a 24/7 operation and… more
    CVS Health (06/21/25)
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  • Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Key ... use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) nurses across various UM departmental teams as needed, ensuring… more
    CVS Health (06/21/25)
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  • Registered Nurse - Utilization

    ERP International (Barksdale AFB, LA)
    **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, ... organization, professional organizations, and community health care facilities concerning Utilization Management . + Participates in in-services and continuing… more
    ERP International (06/18/25)
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  • Nurse Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
    Commonwealth Care Alliance (05/23/25)
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  • Registered Nurse - Utilization

    Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
    …of care. Follows procedures per established policies and guidelines. Responsibilities The Utilization Management (UM) Registered Nurse (RN) executes position ... comprehensive knowledge of clinical appropriateness, functions, processes, and principles of utilization management . Duties include but are not limited to:… more
    Veterans Affairs, Veterans Health Administration (06/18/25)
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  • Utilization Management Nurse

    WellSpan Health (York, PA)
    …effective and quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible for screening ... analysis as required. + Develops and initiates educational programs regarding utilization management principles. + Attends meetings as required.… more
    WellSpan Health (06/14/25)
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  • Utilization Management Nurse

    CVS Health (Concord, NH)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
    CVS Health (06/26/25)
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  • Utilization Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + Interqual + Milliman Commercial Guidelines… more
    Actalent (06/21/25)
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