• Utilization Management

    CVS Health (Jefferson City, MO)
    …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
    CVS Health (10/26/25)
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  • Utilization Management Nurse

    Humana (Jefferson City, MO)
    …help us put health first** Full-Time, Remote Telephonic opportunity 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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  • Clinical Registered Nurse

    Cognizant (Jefferson City, MO)
    …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical more
    Cognizant (10/07/25)
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  • SNF Utilization Management RN…

    Humana (Jefferson City, MO)
    …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    CVS Health (Jefferson City, MO)
    … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
    CVS Health (10/25/25)
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  • Utilization Management Nurse

    CVS Health (Jefferson City, MO)
    …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central or Mountain… more
    CVS Health (10/24/25)
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  • Utilization Management

    CVS Health (Jefferson City, MO)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (10/26/25)
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  • Utilization Management Clinician-…

    CVS Health (Jefferson City, MO)
    … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (10/21/25)
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  • Manager, Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal management and development… more
    Children's Mercy Kansas City (09/16/25)
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  • Clinical Reviewer, Nurse -9am -6pm…

    Evolent (Jefferson City, MO)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by… more
    Evolent (10/21/25)
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