• Utilization Management

    CVS Health (Woonsocket, RI)
    …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
    CVS Health (10/26/25)
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  • Utilization Management RN

    AdventHealth (Altamonte Springs, FL)
    …**Job Location** : Remote **The role you will contribute:** The Utilization Management nurse uses clinical expertise to review for medical necessity ... other related software and databases to perform required actions that encompass Utilization Management . Demonstrates strong analytical, problem solves skills and… more
    AdventHealth (10/24/25)
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  • Utilization Management Nurse

    Humana (Little Rock, AR)
    …help us put health first** Full-Time, Remote Telephonic opportunity 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 Nurse

    Humana (Sacramento, CA)
    …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
    Humana (10/27/25)
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  • Clinical Registered Nurse

    Cognizant (Carson City, NV)
    …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical more
    Cognizant (10/07/25)
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  • SNF Utilization Management RN…

    Humana (Lincoln, NE)
    …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
    Humana (09/12/25)
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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 (09/27/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually...needed for outside services for patients/families; + Conducts daily clinical reviews for utilization /quality management more
    Ventura County (09/21/25)
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  • Utilization Management Nurse

    CVS Health (Carson City, NV)
    … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
    CVS Health (10/25/25)
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  • Utilization Management Appeals…

    CVS Health (Columbus, OH)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... Nurse Consultant plays a key role in resolving clinical complaints and appeals by reviewing medical records and...complaints and appeals by reviewing medical records and applying clinical guidelines for Utilization Management more
    CVS Health (10/12/25)
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