• Clinical Registered Nurse

    Cognizant (Washington, DC)
    …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (10/07/25)
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  • Utilization Management Clinical

    CVS Health (Washington, DC)
    …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (10/26/25)
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  • Utilization Management Nurse

    CVS Health (Washington, DC)
    …Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . **Required Qualifications** + Registered Nurse (RN) ... CVS Health Aetna has an opportunity for a full-time Utilization Management (UM) Nurse Consultant. As a...Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills… more
    CVS Health (10/25/25)
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  • Utilization Management Nurse - Home…

    Humana (Annapolis, MD)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    CVS Health (Annapolis, MD)
    …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
    CVS Health (10/24/25)
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  • Utilization Management Clinical

    CVS Health (Washington, DC)
    …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (10/26/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Clinton, MD)
    …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
    Fresenius Medical Center (09/13/25)
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  • Registered Nurse - Accreditation…

    Veterans Affairs, Veterans Health Administration (Washington, DC)
    Summary The Registered Nurse - Accreditation Coordinator provides fundamental, knowledge-based care while developing technical skills on this assigned unit where ... of any number of regulatory bodies in accordance with VHA Directive 1050.01. Registered Nurse (RN) is responsible and accountable for individual nursing practice… more
    Veterans Affairs, Veterans Health Administration (10/22/25)
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  • Case Manager, Registered Nurse

    CVS Health (Washington, DC)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
    CVS Health (10/23/25)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Annapolis, MD)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse (RN)** in the (appropriate state)… more
    Humana (09/12/25)
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