• Utilization Management Nurse

    CVS Health (Lincoln, NE)
    …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 (07/22/25)
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  • Utilization Management Nurse

    CenterWell (Lincoln, NE)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • Clinical UM Nurse 2

    CenterWell (Lincoln, NE)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
    CenterWell (08/01/25)
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  • Utilization Management Clinical…

    CVS Health (Lincoln, NE)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • Disease Management Nurse - Remote

    Sharecare (Lincoln, NE)
    …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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  • Registered Nurse - Medical/Surgical

    Veterans Affairs, Veterans Health Administration (Omaha, NE)
    Summary The Registered Nurse assigned to the Medical/Surgical Unit, is a professional nurse with a broad-based clinical knowledge that enables him/her to ... reviewed weekly & will be referred if eligible. Responsibilities Medical/Surgical Registered Nurse duties will include, but are not limited to, the following:… more
    Veterans Affairs, Veterans Health Administration (06/13/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Lincoln, NE)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation… more
    CVS Health (07/31/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Lincoln, NE)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... in **Specialty Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (07/31/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Bellevue, NE)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they...be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and… more
    Molina Healthcare (08/02/25)
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  • Field Nurse Practitioner (Jackson, MS)

    Molina Healthcare (NE)
    **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 (07/31/25)
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