- CenterWell (Boise, ID)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... your skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license (RN) with no disciplinary action and ability to obtain non… more
- Magellan Health Services (Boise, ID)
- Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse ... develops discharge plans and oversee their implementation. + Performs quality clinical reviews while educating and making appropriate interventions to advance the… more
- Humana (Boise, ID)
- …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and...a Utilization Management RN working on the OneHome/Home Solutions UM Team, you will have the opportunity to use… more
- Molina Healthcare (Nampa, ID)
- …national, state, and local laws and regulatory requirements affecting the medical and clinical staff. + Marketplace UM reviews + MD licenses required for ... appropriate care at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under-utilization. Assumes a leadership… more
- Humana (Boise, ID)
- …for providing leadership and oversight of the physical health utilization management ( UM ) staff in daily operations. + Uses clinical knowledge, communication ... Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical nursing skills to support the coordination, documentation and… more
- Molina Healthcare (Caldwell, ID)
- **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members...the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. **Required Qualifications** * At least… more