• Utilization Management Nurse

    CVS Health (Des Moines, IA)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in MST or CST zone.… more
    CVS Health (07/11/25)
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  • Disease Management Nurse - Remote

    Sharecare (Des Moines, IA)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (07/12/25)
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  • Pre-Authorization Registered Nurse

    Humana (Des Moines, IA)
    …Occupational and Physical Therapy utilization review + Previous experience in utilization management , case management , discharge planning and/or home ... stakeholders for review depending on case findings. + Educates providers on utilization and medical management processes. + Enters and maintains pertinent… more
    Humana (07/16/25)
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  • Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Iowa City, IA)
    …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... System (ICVAHCS) is currently recruiting for one (1) Full-Time Registered Nurse - Community Care Coordinator position. Responsibilities The VA Midwest Health Care… more
    Veterans Affairs, Veterans Health Administration (07/15/25)
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  • Nurse Navigator

    UnityPoint Health (Waterloo, IA)
    …population, ensuring that adequate discharge plans are in place and completing utilization management and quality review activities. Care is provided through ... activities are concurrently accessible to the healthcare team.Maintains knowledge of utilization management criteria and communicates with Utilization more
    UnityPoint Health (06/21/25)
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  • Registered Nurse (RN) or Licensed Practical…

    Avera (Sioux Center, IA)
    …Christian culture. **Registered Nurse ** **Job Summary** + The RN assists the Resource Nurse in the management and care of their assigned patients by means of ... Nurse ** **Summary** + The LPN assists the registered nurse in the management and care of...Communicates pertinent information to staff. + Displays proper care, utilization , and charging of supplies and equipment used. +… more
    Avera (07/10/25)
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  • Field Family Nurse Practitioner (Palm…

    Molina Healthcare (IA)
    **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home, ... are most receptive including home, nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and… more
    Molina Healthcare (07/05/25)
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  • Nurse Reviewer I

    Elevance Health (Des Moines, IA)
    …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... and experiences:** + Behavioral health background preferred + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
    Elevance Health (07/16/25)
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  • ED Charge RN - Emergency Charge Registered…

    Trinity Health (Davenport, IA)
    **Employment Type:** Full time **Shift:** Evening Shift **Description:** Evening charge nurse 0.9 FTE - begin shift in staffing, transition to charge role at 1500 or ... Click here: MercyOne Genesis | Stronger. Together. As One! As a Charge Nurse at MercyOne, you will provide shift-to-shift leadership for the practice and delivery… more
    Trinity Health (07/08/25)
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  • Care Review Clinician, Prior Auth (RN) Pega Float…

    Molina Healthcare (IA)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... Experience using PEGA **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
    Molina Healthcare (07/12/25)
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