- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
- CVS Health (Columbus, OH)
- …of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment to… more
- CVS Health (Atlanta, GA)
- …solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll apply ... with providers to secure additional information for prior authorization review . ** Remote Work Expectations** + This is...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review or… more
- CVS Health (Phoenix, AZ)
- …solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll apply ... times may vary based on business needs) Location: 100% Remote (US only) **About Us** American Health Holding, Inc....skilled nursing facility. + At least 1 year of Utilization Management experience in concurrent review or… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... or LPN License. + Minimum of one year of utilization review experience and discharge planning in...involving shadowing a team member on-site on Tuesdays and remote shadowing via Teams. Pay and Benefits The pay… more
- CVS Health (Phoenix, AZ)
- …for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the ... times may vary based on business needs) Location: 100% Remote (US only) **About Us** American Health Holding, Inc....intensive outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or… more
- CVS Health (Phoenix, AZ)
- …difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and Transplant, ... in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position… more
- Humana (Tallahassee, FL)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... will be conducted. + Onsite training for the first 1-2 weeks remote position after training Monday through Friday, 8:30am-5:00pm. **Job Description:** + NICE… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
Recent Jobs
-
Recreation Employment - SUN Community Schools (Ages 15+) - Talent Pool
- City of Portland (Portland, OR)
-
Sales Specialist
- Mass Markets (TX)
-
Practical Nurse Licensed 1, 2 or 3
- Louisiana Department of State Civil Service (Reserve, LA)
-
AVP - Casualty Coverage and Construction Defect
- AIG (Chicago, IL)