Utilization Management Nurse jobs

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Nurse-Utilization Review
RN - Registered Nurse. Insurance Case Management, Workers Compensation). 3-5 years of experience in Utilization Review applying screening guidelines (InterQual...
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RN - Utilization Management - Health Insurance
Fallon Health - 55 reviews - Worcester, MA
2 years’ experience as a Utilization Management nurse in a managed care payer preferred. Oversee utilization management decisions completed by Senior Nurse Case...
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Registerd Nurse
TRAC STAFFING - 4 reviews - Fort Smith, AR 72901
$27 an hour
Registered Nurse and State Licensure. Providing case management for patients• Providing specific assessments according to protocols and procedures, clinical...
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UM Nurse Consultant

Aetna - 1,914 reviews - Chantilly, VA  +12 locations
The nurse uses clinical skills to coordinate, document and communicate all aspects of the utilization management program....

Concurrent Review Nurse RN (Florida remote worker )

Florida Blue - 201 reviews - Jacksonville, FL
Home health care, rehab, SNF, utilization review, discharge planning or case management. Experience with Case Management activities that focus on acute and non...

RN Telephonic Utilization Review - Metairie or Baton Rouge

Humana - 2,257 reviews - Metairie, LA
Examine clinical programs information to identify members for specific case management and / or disease management activities or interventions by utilizing...

Utilization Mgmt RN

University of Rochester - 295 reviews - Rochester, NY
Full Time 40 hours Grade 044 Utilization Management. The Utilization Management Nurse role is a unique and exciting opportunity that blends the knowledge of...

Nurse First Response / Utilization Review (virtual / remote)

Conduent - Nashville, TN
Nurse First Response (NFR) / Utilization Review Nurse (URN). URN - Perform prospective, concurrent and retrospective utilization management activities per...

Utilization Management Representative I/II

Anthem, Inc. - 1,872 reviews - Midland, GA  +5 locations
Utilization Management Representative I/II – Midland, GA – 125315. Refers cases requiring clinical review to a Nurse reviewer....

Utilization Management Representative I/II/Ld

Anthem, Inc. - 1,872 reviews - Denver, CO
Utilization Management Representative I/II/Ld – Denver, CO – 125403. Refers cases requiring clinical review to a Nurse reviewer....

Utilization Management RN

Ellis Hospital - 57 reviews - Schenectady, NY
Accurately documents utilization management activities per policy. Minimum one (1) year Utilization Management experience preferred via, industry clinical...

RN or LVN Utilization Management Nurse

Medix - 60 reviews - Torrance, CA
Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize...

UTILIZATION REVIEW RN

McDonough District Hospital - 10 reviews - Macomb, IL
Current Illinois Registered Professional Nurse license. Job Summary As a member of the Advocacy team, the UR Specialist provides leadership in the provision and...
Utilization Review Outpatient Nurse
WellCare - 600 reviews - Tampa, FL 33634
Required A High School or GED Utilization review nurse utilization management managed care health integrated Humana Anthem care centrix pre auths prior auths...
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Utilization Management Technician, Per Diem
AmeriHealth Caritas - 188 reviews - Philadelphia, PA
Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or...
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