- 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
- 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 (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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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