• Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (05/03/25)
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  • Clinical Reviewer, Nurse (Pain Mngt)

    Evolent (Salt Lake City, UT)
    …Stay for the culture. **What You'll Be Doing:** Job description: As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We ... better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
    Evolent (05/16/25)
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  • Appeals Licensed Practical Nurse

    Evolent (Salt Lake City, UT)
    …adjudication of processed appeals. **What You Bring:** + 1-3 years' experience in clinical Appeals Review or Utilization Management Review as an LPN or LVN ... the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact as part of… more
    Evolent (05/16/25)
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  • Clinical Research Nurse

    University of Utah (Salt Lake City, UT)
    …**Open Date** 04/03/2025 **Requisition Number** PRN41558B **Job Title** PS Clinical Nurse Specialist **Working Title** Clinical Research Nurse **Job Grade** ... Rate Range** 47600 to 74609 **Close Date** 07/02/2025 **Priority Review Date (Note - Posting may close at any...roles in the area of clinical expertise. The Clinical Nurse Specialist makes decisions independently and in collaboration with… more
    University of Utah (04/03/25)
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  • Registered Nurse , Case Manager - Oncology…

    CVS Health (Salt Lake City, UT)
    …with transferring patients to lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC recognized accreditation preferred - 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (05/16/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Provo, UT)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
    Molina Healthcare (05/16/25)
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  • Nurse Care Manager

    Intermountain Health (Provo, UT)
    …needs in area(s) of responsibility. Completes documentation as required. + Performs utilization review activities to provide patient appropriate, timely, and ... **Job Description:** The Nurse Case Manager utilizes clinical expertise and critical...+ Case management Certification. + Experience in Case management, Utilization review , and/or discharge planning. **Physical Requirements:**… more
    Intermountain Health (05/13/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Salt Lake City, UT)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is ... To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and objectives of the… more
    Sharecare (05/10/25)
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  • Nurse Care Manager

    Intermountain Health (Murray, UT)
    …accredited institution. Degree will be verified. + Experience in case management, utilization review , or discharge planning. **Physical Requirements:** + Ongoing ... **Job Description:** The Nurse Care Manager works collaboratively with physicians and...team + Personalized Primary Care: + Completes pre-visit planning ( review chart before visit, notify patient of tests needed… more
    Intermountain Health (05/13/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Salt Lake City, UT)
    …Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like to work here?** At ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
    Lincoln Financial (04/30/25)
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