• Utilization Management Nurse

    Humana (Madison, WI)
    …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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
    Humana (09/12/25)
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  • Utilization Management Clinical…

    CVS Health (Madison, WI)
    …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
    CVS Health (11/19/25)
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  • SNF Utilization Management RN

    Humana (Madison, WI)
    **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (09/12/25)
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  • Utilization Management Nurse

    CVS Health (Madison, WI)
    …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
    CVS Health (11/24/25)
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  • Utilization Management Nurse

    Humana (Madison, WI)
    **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
    Humana (11/24/25)
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  • Manager II Utilization Management

    Elevance Health (Waukesha, WI)
    **Title:** Manager II Utilization Management **Hybrid 2:** This role requires associates to be in-office **3** days per week, fostering collaboration and ... is granted as required by law. The **Manager II Utilization Management ** is responsible for overseeing workflow...and Experiences:** + BA/BS in a clinical area plus RN , MFT or LCSW license preferred. + 3 years… more
    Elevance Health (11/21/25)
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  • Clinical Registered Nurse

    Cognizant (Madison, WI)
    …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... 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 (11/25/25)
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  • Utilization Management RN

    CenterWell (Madison, WI)
    …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
    CenterWell (11/26/25)
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  • NCCPAC Revenue Utilization Review (RUR)…

    Veterans Affairs, Veterans Health Administration (Middleton, WI)
    …Revenue, Billing, Insurance Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management (UM), and ... Summary The Revenue Utilization Review (RUR) nurse is under...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (11/25/25)
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  • Director of Case Management ( RN

    Select Medical (Madison, WI)
    …of Case Management ** $10,000 Sign On Bonus **_Clinical license as a registered nurse or respiratory therapist or master's in social work and minimum ... focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with… more
    Select Medical (10/16/25)
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