- 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, discharges and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Charleston, WV)
- **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 (Louisville, 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 ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied… more
- 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
- 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 ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...CCM (Certified Case Manager) **Required Experience (must have):** + 2 to 3 years Utilization Management… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse ...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and ... accreditation standards, and performance measures. Uses emergency and bed management software and utilization data to manage...1 year of professional nursing experience equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Medical...requested authorizations. Refer patients to case management nurse or health coach as appropriate. 2 . ... On 06/05/2025 **Job Overview** **Description** Medical Associates is looking for a ** Utilization Management Nurse ** to join our Health Care Services team!… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Consultant is a registered...nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and ... services, administrative officers, Emergency Department (ED) staff, and Bed Management . The nurse is responsible for applying...1 year of professional nursing experience equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Elevance Health (Morgantown, WV)
- RN Utilization Management /Review Nurse -... management experience and requires a minimum of 2 years clinical, utilization review, or managed ... **Work Hours** : Monday through Friday, 8am - 5pm The **Medical Management Nurse ** (Medicaid Utilization Review) is responsible for review of the… more
- CVS Health (Annapolis, MD)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST and CST… more