- Humana (Little Rock, AR)
- …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… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Cottingham &...- Risk Management Cottingham & Butler/ SISCO RN - Rehab Registered Nurse MercyOne ... 4627707008 Posted On 07/01/2025 Refreshed On 10/23/2025 **Job Overview** ** Utilization Management Nurse ** **Location** :...Dubuque, IA UnityPoint Health Finley Hospital ER Medical Surgical RN - Registered Nurse MercyOne… more
- Humana (Sacramento, CA)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a ... Utilization Nurse Consultant, you will utilize clinical...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
- CVS Health (Atlanta, GA)
- …all with heart, each and every day. **Position Summary** Medicare Predetermination Utilization Management Nurse Consultant position: _Utilization ... /benefit management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN … more
- Elevance Health (Costa Mesa, CA)
- RN Utilization Management Nurse (NICU / Peds) - California (JR169694) **Virtual:** This role enables associates to work virtually full-time, with the ... - 6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of...clinical experience in NICU / Peds strongly preferred. + Utilization management /review within managed care or hospital… more
- Brighton Health Plan Solutions, LLC (NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... regulatory and accreditation requirements. * Duties as assigned. Essential Qualifications * Current Registered Nurse ( RN ) with state licensure. Must retain… more
- CVS Health (Tallahassee, FL)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- Crouse Hospital (Syracuse, NY)
- …and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse ( RN ) to track and manage data ... Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse ( RN ) Position Responsibilities: + Works collaboratively… more
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