• Utilization Management Appeals Nurse

    Humana (Washington, DC)
    …of the appropriate courses of action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in preparation of cases prior to review ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
    Humana (01/18/26)
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  • Appeals Nurse

    Evolent (Washington, DC)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
    Evolent (12/24/25)
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  • Infusion Referral Nurse Sr- REMOTE

    Prime Therapeutics (Washington, DC)
    …the future of pharmacy with us. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE **Job Description** Under supervision, is responsible for performing ... and spreadsheets. + Supports clinical services such as the appeals program. + Participates in meetings and consults with...Qualifications** + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt… more
    Prime Therapeutics (01/16/26)
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