- Omaha Children's Hospital (Omaha, NE)
- …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative,...Compact State Licensure Required and + RN-BC - Case Management Nurse Preferred Children's is the very… more
- CVS Health (Santa Fe, NM)
- …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- Omaha Children's Hospital (Omaha, NE)
- …equal opportunity employer including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case ... variety of settings. + Skills in negotiation and problem solving with utilization management . + Should be a creative, flexible, risk taker. **Licenses and… more
- Humana (Atlanta, GA)
- …of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support ... health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and… more
- Humana (Indianapolis, IN)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- CVS Health (Austin, TX)
- …occasionally per the need of the department.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... And we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the… more
- Centene Corporation (Springfield, IL)
- …either central or eastern time zone with experience in mental health settings and utilization management / review. * Department: PHCO BH UM supporting IL ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- US Tech Solutions (Columbia, SC)
- …Friday, 8:30am-5:00pm. **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical ... skills Behavioral Health or infusion therapy experience + A typical.../or UR experience/Process Appeals requests/can have experience in either Utilization management or Appeals. + Team: Fast… more
- US Tech Solutions (Columbia, SC)
- …medical policies. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more