• Utilization Management…

    CVS Health (Phoenix, AZ)
    …Arizona time zone. No weekends, holidays are required. **Preferred Qualifications** : + Utilization management experience + Clinical experience in Emergency ... internal and external constituents in the coordination and administration of the utilization /benefit management function. Gathers clinical information and… more
    CVS Health (07/26/25)
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  • Utilization Management Onsite…

    Humana (Charleston, WV)
    …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (07/25/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management ...needed for outside services for patients/families; + Conducts daily clinical reviews for utilization /quality management … more
    Ventura County (07/28/25)
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  • Utilization Management Nurse

    Adecco US, Inc. (Minneapolis, MN)
    …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under...Identify and refer all potential quality issues to the Clinical Quality Management Department, and suspected fraud… more
    Adecco US, Inc. (07/15/25)
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  • Registered Nurse - Utilization…

    Veterans Affairs, Veterans Health Administration (Houston, TX)
    Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental knowledge-based care to assigned clients while developing ... Duties (To include but not limited to): The Registered Nurse Utilization Management Registered ...healthcare settings. Knowledge and ability to apply InterQual criteria, utilization management process, clinical documentation… more
    Veterans Affairs, Veterans Health Administration (07/21/25)
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  • Utilization Review Nurse - Case…

    Houston Methodist (The Woodlands, TX)
    …eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and managed ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position...the ideas of others. + Collaborates with the access management team to ensure accurate and complete clinical… more
    Houston Methodist (07/12/25)
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  • Utilization Management Nurse

    Actalent (Sunrise, FL)
    Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the ... activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + InterQual + Milliman Commercial Guidelines +… more
    Actalent (07/29/25)
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  • Registered Nurse - Utilization…

    ERP International (Barksdale AFB, LA)
    **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, ... organization, professional organizations, and community health care facilities concerning Utilization Management . + Participates in in-services and continuing… more
    ERP International (06/18/25)
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  • Utilization Management Nurse…

    CVS Health (Tallahassee, FL)
    …must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate ... internal and external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information and… more
    CVS Health (07/30/25)
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  • Nurse Utilization Management…

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
    Commonwealth Care Alliance (05/23/25)
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