PAS Tampa - Largo, FL 

Clinical Appeals Nurse - Work from Home(Job Number:. At least one year utilization review experience required....

WellSpan Health - Ephrata, PA 3.7

Techniques as needed to prevent over and/or under utilization. 7 Assists with the collection and analysis of utilization patterns and denied cases....

Estimated: $62,000 - $88,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Baylor Scott & White Health - Pflugerville, TX 3.9

The Utilization Review Nurse provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent,...

Estimated: $100,000 - $140,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Cayuga Addiction Recovery Services - Ithaca, NY 

Registered Nurse (RN) (Required). Triage emergent client medical issues and coordinate care with the Nurse Manager, PA, Medical Director and outside providers....

Estimated: $59,000 - $84,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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UnitedHealth Group - Utah +5 locations3.6

3+ years of utilization management experience in a managed care setting. Identify outliers through analysis of clinical outcomes data, utilization / claims data...

Anthem, Inc. - California 3.8

Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information....

Estimated: $50,000 - $65,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Health Information Alliance - Fort Washington, PA 

Current license to practice as a Registered Professional Nurse. Utilization Review is a safeguard against unnecessary and inappropriate medical care....

Estimated: $60,000 - $80,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Medical Mutual of Ohio - Cleveland, OH 4

Registered Nurse with 3 years recent nursing experience with State of Ohio license. Performs utilization management activities to ensure the provision of safe,...

Estimated: $54,000 - $70,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Western Sky Community Care - Roswell, NM +5 locations3.3

Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment...

Estimated: $38,000 - $49,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Carenet Healthcare Services - Lincoln, NE +1 location3.4

The RN Clinical Care Advisor provides telephonic clinical triage assessments, health education, and utilization management services to diverse patients/members....

Estimated: $44,000 - $59,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Ascension (System Office) - Sterling Heights, MI 3.4

Licensed Registered Nurse. Previous Utilization Management experience preferredManaged care (HMO,PPO, Medicare Advantage, Medicaid) experience preferred....

Estimated: $39,000 - $56,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Jzanus Consulting, Inc. - West Hempstead, NY 

Registered Nurse (RN) (Required). We have an opportunity in our West Hempstead office for a RN Medical Record Reviewer position with primary focus on charge...

$35 - $45 an hour

Humana - Texas +2 locations3.7

The UM Specialist contributes to administration of utilization management. We strive to ensure we provide perfect service with one-on-one member interactions as...

Estimated: $25,000 - $36,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Aetna - Sandy, UT 3.8

Registered Nurse with behavioral health experience. This position is for a utilization management clinician. The individual will perform utilization management...

Estimated: $61,000 - $87,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Aetna - Linthicum, MD 3.8

Nursing/Registered Nurse is required. Registered Nurse (RN) is required. Management of Care Management Program in a high volume environment servicing Medicaid...

Estimated: $87,000 - $120,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

SSM Health - Madison, WI 3.7

Previous experience in utilization management or prior authorization reviews. Registered Nurse with current licensure in the State of WI....

BlueCross BlueShield of Kansas City - Kansas City, MO 4.1

1+ year(s) of utilization review, disease management, and/or case management experience. Recognizes, documents and reports inappropriate billing patterns or...

Estimated: $63,000 - $86,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Aledade, Inc. - Bethesda, MD 

Ensure we’re developing not only core knowledge but also problem solving to empower teams to continue transformation beyond the implementation stage and to...

Estimated: $84,000 - $120,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

JanTec, Inc. - Virginia Beach, VA 

Utilizes DRMS (Defense Utilization and Marketing) website for disposal of contract US Government property. Minimum Experience Requirements....

$16 an hour

ProgenyHealth - Plymouth Meeting, PA 

The clinical care nurse serves as a nurse reviewer for admissions, lengths of stay and a facilitator for discharge planning....

Healthfirst - New York, NY 3.6

Registered Nurse (RN). The RN Case Manager, Utilization Management is also responsible for efficient utilization of health services and optimal health outcomes...

Estimated: $71,000 - $89,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Anthem, Inc. - Albany, NY 3.8

This level is expected to be able to perform all of the duties of the Utilization Management Rep II in addition to the following primary duties....

Estimated: $35,000 - $49,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Anthem, Inc. - Albany, NY 3.8

Utilization Management Representative (I, II, or Sr.). Responsible for non-clinical tasks including performing outreach to members to connect them with a nurse...

Estimated: $31,000 - $42,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Niobrara Community Hospital, Lusk, WY - Wyoming 

Registered Nurse (RN). To provide patient care through utilization of the nursing process. Current licensure of Registered Nurse in the State of Wyoming....

Estimated: $58,000 - $73,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Wilson Health - Sidney, OH 3.9

Current license as a Registered Nurse in the State of Ohio. Assist patient and significant other/family member to obtain knowledge regarding their disease...

Estimated: $64,000 - $83,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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The Center for Discovery - Harris, NY 3.4

Provides professional nursing care for individuals with complex conditions utilizing a holistic approach and Nursing Process as governed by the Nurse Practice...

Estimated: $53,000 - $70,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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