- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Cottingham & Butler/...Job TH Ad TH Comments **Similar Jobs** Acute Care RN - Medical Surgical Registered Nurse ... 1 Positions ID: 4627707008 Posted On 07/01/2025 **Job Overview** ** Utilization Management Nurse ** **Location** : Onsite in...Nurse Practitioner - Hospital Medicine Medical Associates ICU RN - Intensive Care Registered Nurse… more
- CVS Health (Des Moines, IA)
- …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... remote role open to candidates with an active RN licensure in the state in which they reside....to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN… more
- Highmark Health (Des Moines, IA)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- CenterWell (Urbandale, IA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Molina Healthcare (IA)
- **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of UTAH or have a compact license._ _This ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
- Prime Therapeutics (Des Moines, IA)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
- Access Dubuque (Dubuque, IA)
- …remotely within Iowa. **Key Responsibilities:** + Provide telephonic case management and utilization review for assigned consumers. + Develop, implement, and ... Bilingual RN Case Manager **Cottingham & Butler/ SISCO** 1...Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred. + **Skills:**… more
- Sharecare (Des Moines, IA)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- UnityPoint Health (West Des Moines, IA)
- …approved days, denials, requests for further information. + In coordination with RN Utilization Management Specialist, communicate opportunities for Peer to Peer ... + Remote : Yes + Area of Interest: Patient Services...Under the guidance and supervision of the Manager of Utilization Management and RN UM Specialists, the… more
- Washington County Hospital and Clinics (Washington, IA)
- …and enhanced functionality. Qualifications EDUCATION AND/OR EXPERIENCE + Bachelor's Degree, Registered Nurse , desired + Three years clinical nursing experience, ... Details Job Location Washington Co Hospital - Washington, IA Remote Type Hybrid Position Type Full Time Job Shift...monitor effectiveness of training efforts. Monitoring may include routine review of reports and utilization data used… more