• Utilization Management Onsite…

    Humana (Charleston, WV)
    **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (07/25/25)
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  • Utilization Management Nurse

    CVS Health (Charleston, WV)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse

    CenterWell (Charleston, WV)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
    CenterWell (08/02/25)
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  • Utilization Management Nurse

    CVS Health (Charleston, WV)
    …on the phone collecting and reviewing clinical information from providers. Utilization management nurses use specific criteria to authorize procedures/services ... to work in a fast paced environment **Preferred Qualifications** - Previous utilization management experience - Compact RN licensure preferred **Education**… more
    CVS Health (08/02/25)
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  • Utilization Management Nurse

    CVS Health (Charleston, WV)
    …listening, speaking, and computer use. **Required Qualifications** + Active, unrestricted **Registered Nurse (RN) license** in state of residence + Minimum of **3 ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
    CVS Health (07/26/25)
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  • Clinical UM Nurse 2

    CenterWell (Charleston, WV)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a… more
    CenterWell (08/01/25)
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  • Utilization Management Clinical…

    CVS Health (Charleston, WV)
    …compassionate. And we do it all with heart, each and every day. ** Utilization Management Clinical Consultant** **Remote - West Virginia** Schedule is ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
    CVS Health (07/12/25)
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  • Utilization Management Clinical…

    CVS Health (Charleston, WV)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • Disease Management Nurse - Remote

    Sharecare (Charleston, WV)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
    Sharecare (07/12/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Charleston, WV)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... in **Specialty Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (08/01/25)
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