- Humana (Boise, ID)
- …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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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 ... we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can… more
- CVS Health (Albany, NY)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management operates 24/7, and work schedules will include evenings, weekends, ... functions. The position is based in a work at home office environment with expectations for productivity and quality....areas. + Prior experience in Managed Care, particularly in Utilization Management . + Preference given to candidates… more
- CVS Health (Topeka, KS)
- …and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and the work schedule...to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and ... most appropriate treatment, care, or services for Enrollees. The Utilization Management Nurse Lead coordinates...Up to 5 associates. **WAH Internet Statement** To ensure Home or Hybrid Home /Office employees' ability to… more
- Humana (Frankfort, KY)
- **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...This hybrid position will have limited hours working at home at the leader's discretion. This is an Onsite… more
- Humana (Tallahassee, FL)
- **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...best for your schedule. **WAH Internet Requirements** To ensure Home or Hybrid Home /Office employees' ability to… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Nurse 2 RN utilizes clinical nursing skills to support ... enhanced licensure, (eNLC) without disciplinary action + 1+ year previous experience in utilization management + 2+ years prior clinical experience preferably in… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member advocate through… more
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