- 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
- 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 (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 (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
- 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
- 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
- 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
- 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
- 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
- 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
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