- Humana (Little Rock, AR)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
- AdventHealth (Tampa, FL)
- …such as heart failure, cancer and other diseases. **The role you'll contribute:** The Utilization Management nurse uses clinical expertise to review patient ... gynecology, internal medicine and transitional year. AdventHealth Tampa is home to the renowned AdventHealth Pepin Heart Institute, a...nursing in an acute care setting - preferred + Utilization Management or Care Management … more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... extended periods, talking on the telephone and typing on the computer. + Work from home position:During work hours, Colleagues who are working from home must be… more
- CenterWell (Little Rock, AR)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous...Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible… more
- Dignity Health (Sacramento, CA)
- …or UM Certification **Knowledge to be successful in the role:** + Understand how utilization management and case management programs integrate + Knowledge of ... **Job Summary and Responsibilities** The ** Utilization Review RN** is responsible for the review...experience - OR - a Masters degree in Case Management or Nursing field in lieu of 1 year… more
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