- Humana (Salt Lake City, UT)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- CVS Health (UT)
- …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development and… more
- Molina Healthcare (Salt Lake City, UT)
- … RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional ... licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of training… more
- CVS Health (UT)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… more
- HCA Healthcare (Ogden, UT)
- …that advance the agenda of unparalleled patient service. What qualifications you will need: + Registered Nurse + BSN preferred + 3 years of nursing experience + ... the opportunity to make a real impact. As a(an) RN Case Manager you can be a...location._** It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential… more
- Intermountain Health (St. George, UT)
- …key metrics, analyze trends, and ensure regulatory compliance. **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice. + ... **Job Description:** The RN Hospital Care Manager I delivers comprehensive care management ... Management Certification + Demonstrated experience in case management , utilization review, value-based care, and/or discharge… more
- University of Utah Health (Salt Lake City, UT)
- …certificate for clinical practice in the State of Utah. + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of ... are integral to our mission. EO/AA_ This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across… more
- CommonSpirit Health Mountain Region (Lehi, UT)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing, physicians, ancillary departments, insurers and post ... hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of acute experience....years of total nursing experience required. + Certified Case Manager (CCM), Accredited Case Manager (ACM- RN… more
- Molina Healthcare (Salt Lake City, UT)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
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