- Actalent (San Antonio, TX)
- …complete cases. Qualifications: + 3+ years of utilization management, concurrent review , prior authorization, utilization review , case management, and ... Immediate Hiring for " Remote Clinical Review Nurses" Job Description: + Review approximately 20 cases a day for medical necessity. + Advocate for and protect… 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 (Austin, TX)
- …+ Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live ... care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care +… more
- CVS Health (Austin, TX)
- …with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any ... care experience is in behavioral health) **Preferred Qualifications** + 1+ years' experience Utilization Review experience + 1+ years' experience Managed Care +… more
- Dartmouth Health (Lebanon, NH)
- …communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote :Fully Remote ... * Area of Interest:Nursing * Pay Range:$79,747.20/Yr. - $127,587.20/Yr. (Based on 40 hours per week, otherwise pro rata) * FTE/Hours per pay period:.01 hrs/per week (per diem/temp) * Shift:Rotating * Job ID:35880 Dartmouth Health offers a total compensation… more
- Highmark Health (Harrisburg, PA)
- …+ Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience **LICENSES AND CERTIFICATIONS** **Required** + Current ... Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization… more
- CVS Health (Columbus, OH)
- …healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position Summary** The Team Lead plays ... 8:00am-5:00pm EST (Shift times vary based on business needs) Location: 100% Remote (US only) **About Us** American Health Holding, Inc. (AHH), a division… more
- Centene Corporation (Springfield, IL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... experience in various mental health settings especially inpatient behavioral health units, utilization management / review , and youth or pediatric services.**… more
- Centene Corporation (New York, NY)
- …related to member care, provider interactions, and facilitates operations within utilization management. + Manages prior authorization, concurrent review , and ... - 5:00 pm with holiday rotation.** **Position Purpose:** Manages Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review team to… more