- 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 (OH)
- …healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position Summary** The Team Lead plays ... 5+ years of clinical practice experience in medical healthcare. + 3+ years Medical Review or Utilization Management experience. + 2+ years of experience with… more
- Actalent (Sunrise, FL)
- Actalent is Hiring a Remote DietitianPosition Purpose: The Registered Dietitian will provide clinical education and support for Ambetter members enrolled in Disease ... + Backed by a non-clinical support team and market-level partnerships. Work Environment Remote Work Pay and Benefits The pay range for this position is $32.00… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments,...on Tuesdays and will be logged into Teams for remote shadowing. Job Type & Location This is a… more
- CVS Health (Workman, MN)
- …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 (MI)
- …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant - Oncology and Transplant to ... EST Hours; Shift times may vary based on business needs) **Location** : 100% Remote (US only) **Position Summary** American Health Holding, Inc. (AHH), a division of… more
- CVS Health (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
- Centene Corporation (New York, NY)
- …clinical license; and a NYS Driver's License or Identification card.** **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
- HonorHealth (AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Penn Medicine (Philadelphia, PA)
- …this rewarding and ** REMOTE RN** role! This role will focus primarily on utilization review which is why **we are seeking individuals who have between 3 ... quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources,… more
Recent Jobs
-
Assistant Research Scientist (PREP0003516) - #Faculty
- Johns Hopkins University (Gaithersburg, MD)