• Utilization Review RN

    Catholic Health Initiatives (Omaha, NE)
    Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive ... **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize… more
    Catholic Health Initiatives (04/23/25)
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  • Care Review Clinician, PA ( RN )…

    Molina Healthcare (NE)
    **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
    Molina Healthcare (06/06/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Omaha, NE)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
    Molina Healthcare (06/11/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Lincoln, NE)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
    Sharecare (05/10/25)
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  • RN Care Coordinator

    Catholic Health Initiatives (Omaha, NE)
    …and make a difference in the lives of our patients!** We are seeking a compassionate and experienced Registered Nurse ( RN ) to join our team as a RN Care ... their practice. 13. Performs other duties as assigned including utilization review as necessary. **Qualifications** **Required** +...Nursing field in lieu of 1 year experience. + RN license in the state(s) covered is required. +… more
    Catholic Health Initiatives (04/26/25)
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  • Assistant Vice President

    Sedgwick (Lincoln, NE)
    …to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines; and to ... provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the provision of these… more
    Sedgwick (05/23/25)
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  • Care Manager RN - Remote

    Highmark Health (Lincoln, NE)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective ** utilization management** strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
    Highmark Health (05/21/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Lincoln, NE)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
    Lincoln Financial (06/10/25)
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  • UM LVN Delegation Oversight Nurse Remote…

    Molina Healthcare (Kearney, NE)
    …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state… more
    Molina Healthcare (06/11/25)
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  • Insurance Case Manager

    Insight Global (Omaha, NE)
    …Worker's Compensation . Prior Experience with Case Management Cost Containment Background - utilization review or managed care null We are a company committed ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
    Insight Global (05/24/25)
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