- Prime Healthcare (Ontario, CA)
- …Responsibilities The Corporate Director of Clinical Utilization Management ... + A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
- CVS Health (Frankfort, KY)
- …Health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky state ... and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant. **MUST RESIDE IN...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
- CVS Health (Baton Rouge, LA)
- …clinician (ie LCSW, LCPC, LMFT, LPCC, LPAT, LPC) in state of Louisiana or a Registered Nurse ( RN ) with unrestricted compact state license with psychiatric ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...licensure (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or a Registered Nurse ( RN ) with unrestricted… more
- The Cigna Group (Bloomfield, CT)
- …duties as required and related to this role. + **Minimum requirements:** + Active unrestricted Registered Nurse ( RN ) license in state or territory of the ... **Position Scope:** Manages/Coordinates an active caseload of inpatient case management cases for Cigna. + Uses clinical ...case management cases for Cigna. + Uses clinical knowledge to assess inpatient admission level of care,… more
- Molina Healthcare (Columbus, OH)
- …+ Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management ... For this position we are seeking a ( RN ) Registered Nurse who...years of experience in case management , disease management or utilization management in… more
- Beth Israel Lahey Health (Boston, MA)
- …and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts + Three years of recent clinical or utilization ... in applying the principles, methods, materials, and equipment necessary in providing utilization management services. Demonstrates clinical expertise to… more
- Humana (Dublin, OH)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... the appropriate courses of action. The Utilization Management Nurse 2 uses clinical ...an impact** **Required Qualifications** + Bachelor's degree + Licensed Registered Nurse ( RN ) in the… more
- US Tech Solutions (Columbia, SC)
- …from your internet provider (non-satellite). + Skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills ... mental health/chemical dependency, orthopaedic, general medicine/surgery. OR, 4 years utilization review/case management / clinical /or combination; 2 of… more
- Actalent (Remote, OR)
- …disease process Top Skills Details nurse , RN , Utilization management , Utilization review,Case management , Clinical review Additional Skills & ... to provide flexible workforce to meet client/customer needs. Skills nurse , RN , Utilization management... RN , Utilization management , Utilization review, Case management , Clinical … more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management / clinical /or combination; 2 of ... clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more