• SNF Utilization Management…

    Humana (Annapolis, MD)
    …and independent determination of the appropriate courses of action. The SNF Utilization Management Registered Nurse 2 uses clinical knowledge, ... caring community and help us put health first** The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
    Humana (08/09/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Washington, DC)
    …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
    AmeriHealth Caritas (09/01/25)
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