• BlueCross BlueShield of Tennessee (Chattanooga, TN)
    …as 4 years of professional work experience in a corporate environment\. + **Licensure:** Registered Nurse \(RN\) with active license in the state of Tennessee or ... + 5 years - progressive leadership experience in care management , utilization management , clinical operations,...+ Analytical: Strong business acumen with sound analytical skills Registered Nurse with BSN highly preferred\. Managed… more
    DirectEmployers Association (11/15/25)
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  • BlueCross BlueShield of Tennessee (Chattanooga, TN)
    BlueCross BlueShield of Tennessee \(BCBST\) is seeking a skilled and compassionate Registered Nurse to join our fast\-paced, high\-performing team\. In this ... care are essential for success in this role\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as… more
    DirectEmployers Association (11/19/25)
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  • Clinical Registered Nurse

    Cognizant (Nashville, TN)
    …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (11/15/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Johnson City, TN)
    …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Summary The UM Nurse shares the responsibility for planning, implementation, and...Duties include: - Works with the medical center's Quality Management office to promote quality in the Medical Center… more
    Veterans Affairs, Veterans Health Administration (11/19/25)
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  • Utilization Management Nurse

    Humana (Nashville, TN)
    …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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    Humana (Nashville, TN)
    **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 (11/16/25)
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  • Utilization Management Nurse

    CVS Health (Nashville, TN)
    …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
    CVS Health (11/21/25)
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  • RN Utilization Specialist/Review…

    YesCare Corp (Brentwood, TN)
    …as indicated. + Communicate and guide staff and physicians regarding utilization management program development, implementation, and evaluation and ... projects on an as needed basis. **Key Qualifications:** + Registered Nurse (RN) active license + No...license + No less than 5 years' experience in utilization management , case management , quality… more
    YesCare Corp (10/30/25)
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  • SNF Utilization Management RN…

    Humana (Nashville, TN)
    **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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  • Utilization Management Clinical…

    CVS Health (Nashville, TN)
    …and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
    CVS Health (11/19/25)
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