• Utilization Management Nurse

    Humana (Columbus, OH)
    **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 ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
    Humana (01/16/26)
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  • Utilization Management Nurse

    Humana (Indianapolis, IN)
    …caring community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
    Humana (01/13/26)
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  • SNF Utilization Management RN…

    Humana (Jackson, MS)
    **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 ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
    Humana (12/12/25)
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  • Utilization Management RN - Physical…

    Humana (Oklahoma City, OK)
    …documentation, and communication of medical services and benefit administration determinations. The Utilization Management Nurse 2 's work assignments ... barriers to helping people achieve their best health. The Utilization Management (UM) Nurse 2 uses clinical nursing skills to support the coordination,… more
    Humana (01/13/26)
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  • Clinical UM Nurse

    CenterWell (Austin, TX)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
    CenterWell (01/14/26)
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  • Registered Nurse - Utilization

    Veterans Affairs, Veterans Health Administration (Milwaukee, WI)
    Summary The Utilization Management (UM) Registered Nurse ...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and ... next care levels along the care continuum. Responsibilities The Utilization Management (UM) Registered Nurse ...1 year of professional nursing experience equivalent to the Nurse I, Level 2 ; OR a Master's… more
    Veterans Affairs, Veterans Health Administration (01/14/26)
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  • Utilization Management Registered…

    Katmai (Fort Carson, CO)
    …American Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM ... Provide a comprehensive utilization review (UR) and utilization management (UM) program for all TRICARE...active, and unrestricted license to practice as a registered nurse . + Must be a graduate from a college… more
    Katmai (11/26/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... or Medical Service Coordinator, CCS.** -OR- OPTION II: Two ( 2 ) years of experience as a registered nurse...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management more
    The County of Los Angeles (12/25/25)
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  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN...clinical experience in an acute hospital setting. At least 2 years of Utilization Management /Case ... nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN… more
    LA Care Health Plan (12/20/25)
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  • Revenue Utilization Review (RUR)…

    Veterans Affairs, Veterans Health Administration (Smyrna, TN)
    …clinical denials. Provides feedback as appropriate, for performance improvement, utilization management , and compliance related issues. Conducts precertification ... Billing, Insurance Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management (UM),...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN… more
    Veterans Affairs, Veterans Health Administration (01/14/26)
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