Care Manager
using InterQual or Milliman Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure...
Lugar: Snellville, GA | 23/05/2026 01:05:27 AM | Salario: S/. No Especificado | Empresa: Piedmont Healthcare Inc.
RN Transitional Care Navigator - Population Health
within established protocols Completes Utilization Management for assigned patients. Applies Milliman Care Guidelines (Indicia...
Lugar: Skokie, IL | 23/05/2026 00:05:55 AM | Salario: S/. No Especificado | Empresa: Edward-Elmhurst Health
Appeals and Grievances - RN, Senior
from an authorized representative. The RNs perform first level appeal reviews for members utilizing Milliman Care Guidelines, Member...
Lugar: Long Beach, CA | 22/05/2026 20:05:56 PM | Salario: S/. No Especificado | Empresa: Blue Shield of California
Director of Case Management - Utilization Management
and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...
Lugar: Inglewood, CA | 22/05/2026 20:05:14 PM | Salario: S/. $108160 - 163800 per year | Empresa: Prime Healthcare
Director of Case Management - Utilization Management
and knowledge in basic to intermediate computer skills. 1. Current BCLS certificate preferred. 2. Knowledge of Milliman Criteria...
Lugar: Inglewood, CA | 22/05/2026 18:05:23 PM | Salario: S/. $108160 - 163800 per year | Empresa: Centinela Hospital Medical Center
Utilization Management Nurse RN
required, but Bachelor’s degree preferred. Basic knowledge of medical necessity criteria such as Milliman Care Guidelines or Interqual...
Lugar: Louisville, KY | 22/05/2026 18:05:09 PM | Salario: S/. No Especificado | Empresa: Signature HealthCARE
Utilization Management (UM) – Pre-Service (Remote | California RN / LVN | Pacific Time Schedule)
for medical necessity across inpatient and outpatient services, applying CMS guidelines and Milliman Care Guidelines (MCG... (LCD, NCD) to assist in determinations of referrals and utilize Milliman Care Guidelines (MCG) to assist in determinations...
Lugar: California | 22/05/2026 00:05:33 AM | Salario: S/. $77905 - 116858 per year | Empresa: Alignment Healthcare
Inpatient Review Nurse (Remote, Must have California LVN / RN License)
: Experience: Required: Minimum 3 years of general case management skills. Minimum of two years of experience utilizing Milliman...
Lugar: California | 21/05/2026 18:05:00 PM | Salario: S/. $77905 - 116858 per year | Empresa: Alignment Healthcare
Registered Nurse - Utilization Management - Full Time
or current multi state license required. Effective Jan 2026: Current MCG (Milliman Clinical Guideline) certification...
Lugar: Egg Harbor, WI - New Jersey | 21/05/2026 02:05:53 AM | Salario: S/. No Especificado | Empresa: AtlantiCare
CASE MANAGER
-A and Milliman Guidelines and third party insurance requirements preferred. Experience in gathering information, monitoring...
Lugar: Miami, FL - Dayton, OH | 21/05/2026 01:05:10 AM | Salario: S/. No Especificado | Empresa: Premier Health