• Utilization Review RN Point…

    Trinity Health (Des Moines, IA)
    …Iowa (IA), MercyOne Des Moines Join the MercyOne Family! We are looking to hire a Utilization Review RN ! Responsible for the review of inpatient and ... discharge. + Carries out hospital programs and principles of utilization review in compliance with hospital policies...SKILLS AND ABILITIES REQUIRED:** + Current licensure as a registered nurse in the State of Iowa.… more
    Trinity Health (07/30/25)
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  • Utilization Management Nurse…

    CVS Health (Des Moines, IA)
    …without personal distractions to meet quality and metric expectations. **Required Qualifications** + Registered Nurse ( RN ) - active license. + 3+ Years ... Director referral as needed. Assists management with training new nurse reviewers/business partners or vendors to include initial and...of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience.… more
    CVS Health (08/01/25)
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  • RN - Utilization Review

    UnityPoint Health (Cedar Rapids, IA)
    …S + Shift: 40 Hours Per Week + Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of high-quality health...degree in a health care related field or an RN + Two years of behavioral health work experience.… more
    UnityPoint Health (07/22/25)
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  • Utilization Management Nurse…

    CVS Health (Des Moines, IA)
    …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... opportunities to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN licensure… more
    CVS Health (07/22/25)
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  • Supervisor, Care Review ( RN )

    Molina Healthcare (Sioux City, IA)
    …and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review , and/or other utilization management ... leadership skills. **Required License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) in good standing. + MULTI STATE… more
    Molina Healthcare (07/27/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Cedar Rapids, IA)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (07/27/25)
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  • Care Review Clinician, Inpatient…

    Molina Healthcare (IA)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (06/20/25)
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  • Care Review Clinician, PA ( RN…

    Molina Healthcare (Cedar Rapids, IA)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (07/17/25)
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  • Case Manager Registered Nurse…

    CVS Health (Des Moines, IA)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (07/31/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Des Moines, IA)
    …care - Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... a hospital setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
    CVS Health (07/31/25)
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