Utilization Management Nurse Jobs

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health

OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the atten

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the general direction of the Utilization Management Manager, the Utilization Management Nu

WHO WE ARE NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all popul

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with

Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and medical necessity reviews and

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions

Job Summary: Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating medical services, treatments, and procedures. This role identifies trends for opportunitie

ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company committed to providing better data that translates into better decision-making for our clients. We are at the forefront of innovation in our space, and our success is driven by a dynamic team pas

Anticipated End Date:2026-11-30 Position Title:Utilization Management Rep I (US) Job Description: Job Description Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions,

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

Anticipated End Date:2026-11-26 Position Title:Utilization Management Rep I (US) Job Description: Utilization Management Representative I (US) Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonom

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

Anticipated End Date:2026-11-23 Position Title:Utilization Management Rep I (US) Job Description: Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maxim

Anticipated End Date:2026-11-23 Position Title:Utilization Management Rep I Job Description: Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum fl

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in e