• Utilization Management Nurse…

    Humana (Jackson, MS)
    …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
    Humana (09/12/25)
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  • SNF Utilization Management RN…

    Humana (Jackson, MS)
    **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 (09/12/25)
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  • UM Behavioral Health Nurse

    Humana (Jackson, MS)
    **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
    Humana (09/09/25)
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  • Disease Management Nurse - Remote

    Sharecare (Jackson, MS)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
    Sharecare (08/13/25)
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  • Infusion Referral Nurse Sr- REMOTE/Oncology…

    Prime Therapeutics (Jackson, MS)
    …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At ... drives every decision we make. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE/Oncology exp required **Job Description** Under supervision, is responsible… more
    Prime Therapeutics (09/04/25)
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  • Family Health Advocate - Remote

    Sharecare (Jackson, MS)
    …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
    Sharecare (09/03/25)
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  • RN Care Manager I

    Intermountain Health (Jackson, MS)
    …in care management /navigation or closely related field including Utilization Management , discharge planning, managed care, health promotion, health ... comprehensive medical, behavioral, and social needs of members while promoting self- management , quality, and cost-effective outcomes. **Essential Functions** + The … more
    Intermountain Health (09/10/25)
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