LoginRegister

Utilization Management Nurse jobs

Now available 136 results are consistent

Sort by:relevance - date

UTILIZATION MANAGEMENT NURSE CONSULTANT

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

CompanyCvs Health
AddressHarrisburg, PA
CategoryAccounting/Finance
Salary$29.10 - $62.31 an hour
Job typeFull-time
Date Posted 6 days ago See detail

Utilization Management Nurse Consultant

Cvs Health

Harrisburg, PA

$29.10 - $62.31 an hour

Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the comp...

6 days ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Hartford, CT

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

2 weeks ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Springfield, IL

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

2 weeks ago seen See more...

Utilization Management Nurse - Dallas, TX

Adecco

Dallas, TX

$ 80000 - $ 90000 / Year

Five years inpatient clinical nursing experience in an acute care hospital setting required.. Minimum of two years Utilization Management acute care setting experience required. . Minimum of one-year drafting and submitting reco...

3 weeks ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Columbus, OH

Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. We are health care innovators.Fundamentals:Through the use of cli...

3 weeks ago seen See more...

Texas Institute Utilization Management Nurse -Dallas

Adecco

Dallas, TX

$ 80000 - $ 90000 / Year

Five years inpatient clinical nursing experience in an acute care hospital setting required. Minimum of two years Utilization Management acute care setting experience required. Minimum of one year drafting an...

4 weeks ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Phoenix, AZ

1+ year varied Utilization Management experience within an inpatient/Outpatient setting, concurrent review or prior authorization. 5+ years of variety clinical experience required including acute care, home health, or long term ca...

4 weeks ago seen See more...

Onsite/Remote- Sr Utilization Management Nurse RN Onsite or Remote

Optum

Boston, MA

$90.6K - $115K a year

Audit entire medical record for accuracy of the coding on the MMQ to support payment to the nursing facility. Answer patient questions regarding care (medication, treatment) and benefits. Discuss Patient Care specifics with peers...

a month ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Trenton, NJ

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.. Gathers clinical informat...

a month ago seen See more...

Associate Director, Utilization Management Nursing - VA Medicaid

Humana

Virginia, United States

$102,200 - $128,000 a year

Serves as a liaison between Humana and the Commonwealth regarding prior authorization reviews, prepayment retrospective reviews, and any additional Utilization Management functions. Coordinates with the Clinical Leadership team to...

2 months ago seen See more...

Utilization Management Nurse

One Senior Care

Erie, PA

9 Paid Holidays. 3 Weeks and 1 Day of Paid Time Off Accrued from the Date of Hire for Full-Time Employees. Annual Pay increases for Performance. Medical, Dental, & Vision. Free Life and AD&D Insurance Plan. Health Savings and Flex...

2 months ago seen See more...

Utilization Management Nurse

Solis Health Plans

Miami, FL

Conduct concurrent and retrospective utilization review for inpatient, observation or SNF services. Conducts clinical reviews of proposed services against appropriate criteria/guidelines to determine medical necessity, benefit eli...

2 months ago seen See more...

RN Utilization Management Nurse - Remote in OR

Unitedhealth Group

Portland, OR

Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Perform all function...

2 months ago seen See more...

Sr Utilization Management Nurse RN Onsite/Remote- MA

Optum

Boston, MA

$93.3K - $118K a year

Audit entire medical record for accuracy of the coding on the MMQ to support payment to the nursing facility. Answer patient questions regarding care (medication, treatment) and benefits. Discuss Patient Care specifics with peers...

2 months ago seen See more...

Behavioral Health Utilization Management Nurse

United Claim Solutions Llc

Remote

$60.5K - $76.6K a year

Conduct timely reviews of UM activities, including prospective, concurrent, and retrospective reviews and apply to summary plan documents or other resources related to the request. Collaborate with appropriate parties to apply the...

2 months ago seen See more...

Utilization Management Nurse RN

Optum

Bangor, ME

$58,300 - $114,300 a year

Validates authorization for all procedure / bedded patients UM pre-admission. Ensuring acquisition of pre-certification authorization, urgent/emergent authorizations, continued stay authorizations, and authorizations for post-acut...

2 months ago seen See more...

Utilization Management Nurse Consultant

Cvs Health

Sacramento, CA

$29.50 - $63.75 an hour

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Gathers clinical informati...

2 months ago seen See more...

Utilization Management Nurse

Cottingham & Butler

Dubuque, IA

$61.4K - $77.8K a year

We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients, but that and prefers working in a professional office setting with daytime office hours and week...

2 months ago seen See more...

Utilization Management Nurse 2

Humana

Boise, ID

The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge an...

2 months ago seen See more...

Nurse IV (Utilization Management)

Department Of Veterans Affairs

Vancouver, WA

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

4 weeks ago seen See more...

Utilization Management Clinical Nurse Consultant

Cvs Health

Phoenix, AZ

3+ years clinical practice experience required.. Must have a active and unrestricted RN Licensure in the state of Arizona or Compact RN licensure. Utilization management experience preferred.. Acute care setting experience preferr...

4 weeks ago seen See more...

Registered Nurse (RN), Utilization Management - Adolescent Psych - PRN - Now Hiring

Denver Health

Denver, CO

$34.45 - $51.68 per hour

Works closely with other DHHA staff members including providers, nursing, insurance personnel, scheduling staff, staff in other departments.. (20%). Participates in care planning and discharge planning with the staff, providers an...

a month ago seen See more...

Registered Nurse (RN) - Utilization Management (Remote)

Uva Health

Charlottesville, VA

$71,988.80 - $115,190.40 a year

They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. All Utilization Management activities are performed in accordance with the mission vision and values of UVA...

2 months ago seen See more...

Utilization Management LVN Nurse - Remote

Conifer Value

Frisco, TX

$27.30 - $40.95 an hour

Responsible for providing timely referral determination by accurate:Usage of the Milliman Care Guidelines.Identification of referrals to the medical director for review.Appropriate letter language (i.e. denials).Appropriate sele...

2 months ago seen See more...

Utilization Management Registered Nurse

Wexford Health

Sylvania, PA

Work with patients and providers for the patients best interests by helping to ensure appropriate care and maximizing clients medical benefits; Review clinical information provided by the Hospital Utilization Management Departm...

2 months ago seen See more...

Utilization Management Clinical Registered Nurse (RN) - Clinic

Texas Children's Hospital

Bellaire, TX

In addition, discharge planning and provider education are major components of this process.Think you've got what it takes?Responsibilities* Analyze submitted information including clinical assessments, treatment plan, regulatory...

2 months ago seen See more...

Registered Nurse - Utilization Manager

Erp International

Little Rock Air Force Base, AR

Founded in 2006, ERP is headquartered in Laurel, MD and maintains satellite offices in Montgomery, AL and San Antonio, TX - plus project locations nationwide. Performs prospective, concurrent, and/or retrospective utilization revi...

2 months ago seen See more...

Utilization Management Specialist

Kaizen Clinical Partners, Inc.

McAllen, TX

$44.9K - $56.8K a year

Analyze electronic medical records. Focus on evaluating the utilization of healthcare services, treatments, and procedures. Utilize retrospective reviews and other UM tools to identify opportunities for improvement and optimize pa...

3 days ago seen See more...

Utilization Management Specialist

Group Health Cooperative Of Eau Claire

Altoona, WI

$41.5K - $52.5K a year

Applies clinical experience, health plan benefit structure, health management policies and procedures, and claims payment knowledge to authorization reviews. Leverages clinical knowledge, business rules, regulatory guidelines and...

3 days ago seen See more...

Nurse Case Manager/Utilization Review Nurse I

State Of Vermont

Burlington, VT

80% State paid medical premium and a dental plan at no cost for employees and their families. Work/Life balance: 11 paid holidays each year and a generous leave plan. State Paid Family and Medical Leave Insurance (FMLI). Two ways...

a month ago seen See more...

see more

Fastest job search tips

Search on Google

"Keyword" + 123work.net

For example: Utilization Management Nurse jobs 123work.net

Home
Create Cover Letter
Create Resume
Account
More