• Utilization Management Nurse

    Humana (Lincoln, NE)
    …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 (Lincoln, NE)
    **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 (Lincoln, NE)
    **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 (Lincoln, NE)
    …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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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Omaha, NE)
    …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
    Molina Healthcare (08/20/25)
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  • Infusion Referral Nurse Sr- REMOTE

    Prime Therapeutics (Lincoln, NE)
    …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At ... and drives every decision we make. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE **Job Description** Under supervision, is responsible for performing… more
    Prime Therapeutics (09/04/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Grand Island, NE)
    …and acting on adverse events and action thresholds. + Oversees facility's Home Therapies Program if applicable. + Accountable for compliance with all applicable ... and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely… more
    Fresenius Medical Center (07/29/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Omaha, NE)
    …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
    Fresenius Medical Center (08/19/25)
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  • Medical Director

    Molina Healthcare (Omaha, NE)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (09/12/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Grand Island, NE)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (08/28/25)
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