Registered Nurse Utilization Management (UMRN) Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C.
Registered Nurse Utilization Management (UMRN) Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C.
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN ...
Utilization Management Denials Nurse
Annapolis, MD · On-site
$34 - $55/hr
Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN ...
Utilization Management Denials Nurse
Annapolis, MD · On-site
$34 - $55/hr
Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN ...
The ideal candidate is a licensed RN (or other clinical degree / license) with significant experience in utilization management, care management, prior authorization, clinical review, medical ...
The ideal candidate is a licensed RN (or other clinical degree / license) with significant experience in utilization management, care management, prior authorization, clinical review, medical ...
Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred ... Experience conducting utilization management reviews specific to a Medicare population across ...
Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred ... Experience conducting utilization management reviews specific to a Medicare population across ...
Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred ... Experience conducting utilization management reviews specific to a Medicare population across ...
Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred ... Experience conducting utilization management reviews specific to a Medicare population across ...
Utilization Management Coordinator
Glen Burnie, MD · On-site
$386K/yr
... Nursing, is required. Knowledge, Skills and Abilities 1. Knowledge of utilization management is ... preferred. 2. Highly effective verbal and written skills are required. 3. Strong communication ...
Utilization Management Coordinator
Glen Burnie, MD · On-site
$386K/yr
... Nursing, is required. Knowledge, Skills and Abilities 1. Knowledge of utilization management is ... preferred. 2. Highly effective verbal and written skills are required. 3. Strong communication ...
... Nursing, is required. Knowledge, Skills and Abilities 1. Knowledge of utilization management is ... preferred. 2. Highly effective verbal and written skills are required. 3. Strong communication ...
... Nursing, is required. Knowledge, Skills and Abilities 1. Knowledge of utilization management is ... preferred. 2. Highly effective verbal and written skills are required. 3. Strong communication ...
Registered Nurse - Utilization Management ID 2026-25308 Category Registered Nurse specialties - Case Manager Facility DOD / MTF - Maryland - Andrews Air Force Base Spectrum Healthcare Resources has ...
Registered Nurse - Utilization Management ID 2026-25308 Category Registered Nurse specialties - Case Manager Facility DOD / MTF - Maryland - Andrews Air Force Base Spectrum Healthcare Resources has ...
Utilization Reviewer
Largo, MD · On-site
$40.61 - $60.96/hr
... Nursing, is required One year of experience in case management or utilization management with knowledge of payer mechanisms and utilization management is preferred. Two years' experience in acute ...
Utilization Reviewer
Largo, MD · On-site
$40.61 - $60.96/hr
... Nursing, is required One year of experience in case management or utilization management with knowledge of payer mechanisms and utilization management is preferred. Two years' experience in acute ...
UM Technician
Washington, DC · On-site
$27.02 - $36.78/hr
Responsibilities: The Utilization Management Technician functions under the direction of the ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...
UM Technician
Washington, DC · On-site
$27.02 - $36.78/hr
Responsibilities: The Utilization Management Technician functions under the direction of the ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...
Utilization Mangement Technician
Washington, DC · On-site
$27.02 - $36.78/hr
Responsibilities: The Utilization Management Technician functions under the direction of the ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...
Utilization Mangement Technician
Washington, DC · On-site
$27.02 - $36.78/hr
Responsibilities: The Utilization Management Technician functions under the direction of the ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...
Utilization Mangement Technician
Washington, DC · On-site +1
$27.02 - $36.78/hr
Responsibilities: The Utilization Management Technician functions under the direction of the ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...
Utilization Mangement Technician
Washington, DC · On-site +1
$27.02 - $36.78/hr
Responsibilities: The Utilization Management Technician functions under the direction of the ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...
Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing ... Utilization management experience in a managed care organization preferred Licensure * Requirements ...
Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing ... Utilization management experience in a managed care organization preferred Licensure * Requirements ...
Behavioral Health UM Review
Washington, DC · On-site +1
Role Overview Under the direction of the Supervisor, the Behavioral Health Utilization Management ... Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing ...
Behavioral Health UM Review
Washington, DC · On-site +1
Role Overview Under the direction of the Supervisor, the Behavioral Health Utilization Management ... Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing ...
Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing ... Utilization management experience in a managed care organization preferred Licensure * Requirements ...
Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing ... Utilization management experience in a managed care organization preferred Licensure * Requirements ...
Weekday Cvs Utilization Management Nurse information
What is a Weekday CVS Utilization Management Nurse?
A Weekday CVS Utilization Management Nurse is a registered nurse who works for CVS Health, focusing on evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient cases, coordinating with healthcare providers, and ensuring that treatments and services meet established guidelines and insurance requirements. These nurses typically work regular weekday hours, rather than nights or weekends. They play a key role in helping patients receive appropriate care while also managing healthcare costs for the organization.
What are the key skills and qualifications needed to thrive as a Weekday CVS Utilization Management Nurse?
To thrive as a Weekday CVS Utilization Management Nurse, you need a valid RN license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with healthcare management software, insurance guidelines, and medical coding systems such as ICD-10 is typically required. Exceptional critical thinking, attention to detail, and effective communication help nurses advocate for appropriate patient care while collaborating with providers and payers. These skills ensure proper resource utilization, regulatory compliance, and optimal patient outcomes in a managed care setting.
How does a Weekday CVS Utilization Management Nurse typically collaborate with physicians and case managers?
As a Weekday CVS Utilization Management Nurse, you will regularly interact with physicians and case managers to review patient care plans and ensure appropriate resource utilization. This role involves evaluating medical records, discussing treatment options, and providing clinical recommendations to support cost-effective, quality care. Effective communication and teamwork are essential, as you’ll serve as a bridge between clinical staff, patients, and administrative teams to coordinate authorizations and resolve coverage questions.
What is the difference between Weekday Cvs Utilization Management Nurse vs Weekend Cvs Utilization Management Nurse?
| Aspect | Weekday Cvs Utilization Management Nurse | Weekend Cvs Utilization Management Nurse |
|---|---|---|
| Work Schedule | Monday to Friday, standard business hours | Weekend shifts, typically Saturday and Sunday |
| Certifications | RN license, utilization review certification often preferred | RN license, utilization review certification often preferred |
| Work Environment | Office-based, healthcare setting, insurance company | Office-based, healthcare setting, insurance company |
| Job Responsibilities | Review medical necessity, authorize services, coordinate care | Review medical necessity, authorize services, coordinate care |
The main difference between Weekday Cvs Utilization Management Nurse and Weekend Cvs Utilization Management Nurse lies in their work schedule. Both roles require similar certifications, responsibilities, and work environments, but the weekday nurse works during standard business hours, while the weekend nurse covers weekend shifts. Both positions are essential for continuous patient care and insurance operations.
What are the most commonly searched types of Cvs Utilization Management Nurse jobs in Washington?
The most popular types of Cvs Utilization Management Nurse jobs in Washington are:
Other
Posted 27 days ago
Job description
Registered Nurse Utilization Management (UMRN)
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C.
Requirements:
- Associates Degree of Nursing
- Current, full, active, and unrestricted license to practice as a Registered Nurse (Any State)
- Must have at least 36 months of total nursing experience in direct patient care clinical setting. Must have utilization management, utilization review or case management experience for 24 recent consecutive months
- Certified/certification eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses, or Certified Informatics Nursing, Ambulatory Care Nursing, Medical-Surgical Nursing, or Nursing Case Management through the American Nurses Credentialing Center.
- Highly organized, self-directed worker able to function in a high-volume environment without distractions.
- Strong verbal and written communication skills.
- Proficient level of experience with Microsoft Office applications and strong technical aptitude.
Work Schedule:
- Monday - Friday
- No nights and weekends
- 8 hours a day
Company Overview:
Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals.
EOE/Disabled/Veterans
About Spectrum Healthcare Resources
Sourced by ZipRecruiter
Spectrum is a leading organization that provides program management and physician and clinical staffing services to United States Military Treatment Facilities, VA Clinics and Federal Agencies. We are dedicated to the markets we serve, leading our organization’s experience for almost three decades.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Saint Louis, MO, US
Year founded
1988