• UM Behavioral Health…

    Humana (Madison, WI)
    …our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are… more
    Humana (11/27/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Madison, WI)
    …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more
    Highmark Health (11/06/25)
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  • Care Review Clinician, PA (RN)

    Molina Healthcare (Madison, WI)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional travel to other Molina offices or… more
    Molina Healthcare (10/26/25)
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