• Utilization Management Nurse

    CVS Health (Frankfort, KY)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
    CVS Health (08/01/25)
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  • Utilization Management Nurse

    CVS Health (Frankfort, KY)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
    CVS Health (07/30/25)
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  • Utilization Management Nurse

    CVS Health (Frankfort, KY)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse

    CVS Health (Frankfort, KY)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... weeks on camera training required 100% participation during 8:30am-5pm Monday-Friday. * A Registered Nurse that must hold an unrestricted license in their state… more
    CVS Health (08/02/25)
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  • Utilization Management Nurse

    Signature Healthcare (Louisville, KY)
    …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
    Signature Healthcare (07/18/25)
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  • Utilization Management Nurse

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

    CenterWell (Frankfort, KY)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
    CenterWell (08/02/25)
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  • Clinical UM Nurse 2

    CenterWell (Frankfort, KY)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
    CenterWell (08/01/25)
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  • Registered Nurse RN Home…

    AdventHealth (Manchester, KY)
    …or Clay County depending on RN . **The role you'll contribute:** The Home Health Registered Nurse ( RN ) Care Manager is a professional nurse who ... and directs the home care patient's care based on individual patient needs. The RN Care Manager is responsible for independent management of the Home Health… more
    AdventHealth (05/09/25)
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  • Charge Registered Nurse - RN

    Fresenius Medical Center (Madisonville, KY)
    …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
    Fresenius Medical Center (07/17/25)
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