• 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 (01/13/26)
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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 (01/16/26)
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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 (12/12/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Lincoln, NE)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (01/17/26)
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  • Clinical UM Nurse

    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 ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
    CenterWell (01/14/26)
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  • Field Nurse Practitioner (Omaha, NE)

    Molina Healthcare (Omaha, NE)
    …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… more
    Molina Healthcare (01/06/26)
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  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent (Lincoln, NE)
    …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
    Evolent (12/10/25)
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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 ... the future of pharmacy with us. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE **Job Description** Under supervision, is responsible for performing… more
    Prime Therapeutics (01/16/26)
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  • Nurse Navigator - Nephrology

    Omaha Children's Hospital (Omaha, NE)
    …as necessary to coordinate care relating to regulatory requirements and benefits management ( Utilization management , authorizations team etc) * Identifies ... Maintains a central role in coordination, communication, education, and care management for timely, efficient, and cost-effective care across multiple healthcare… more
    Omaha Children's Hospital (01/15/26)
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  • Nurse Navigator - Dialysis

    Omaha Children's Hospital (Omaha, NE)
    …as necessary to coordinate care relating to regulatory requirements and benefits management ( Utilization management , authorizations team etc) * Identifies ... Maintains a central role in coordination, communication, education, and care management for timely, efficient, and cost-effective care across multiple healthcare… more
    Omaha Children's Hospital (01/15/26)
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