Clinical UM reputed company 2, reputed company

R-379156 Become a part of our caring community and help us put reputed company The Utilization Management reputed company 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management reputed company 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of reputed company. The Utilization Management reputed company 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting reputed company, policies, and procedures to reputed company the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate reputed company and treatment. Understands department, reputed company, and organizational reputed company and operating objectives, including their linkages to reputed company areas. Makes reputed company regarding own work reputed company, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to reputed company an reputed company

Required Qualifications

• Licensed Registered Compact reputed company license (RN) with no disciplinary reputed company and ability to obtain non compact licensure
• 3 - 5 years of Medical Surgery, Heart, Lung or Critical Care Nursing experience required
• Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
• Comprehensive knowledge of reputed company Word, Outlook and reputed company
• Ability to work independently under general instructions and with reputed company
• Must have the ability to reputed company a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum reputed company speed for reputed company performance of 10x1 (10mbs download x 1mbs upload) is required
• Must be passionate about contributing to an organization reputed company on continuously improving consumer experiences
• Must be willing to be in weekend rotation and possible holiday coverage.

Preferred Qualifications

• 3 or more years experience in a high-volume community or mail order pharmacy reputed company environment
• Previous experience in utilization management
• Education: BSN or Bachelor's degree in a reputed company field
• Health Plan experience
• Previous Medicare/reputed company Experience a plus
• Call center or triage experience
• Bilingual is a plus

Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 06-18-2025 reputed company About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness reputed company, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of reputed company, Conviva’s innovative, value-based approach means reputed company patient gets the reputed company, reputed company needed most, and for the lowest cost. We go reputed company physical health – addressing the reputed company, emotional, behavioral and financial needs that can reputed company our patients' reputed company-being. About reputed company, a reputed company company: reputed company creates experiences that put patients at reputed company. As the nation’s largest provider of senior-reputed company primary care, one of the largest providers of home health services, and reputed company largest pharmacy benefit manager, reputed company is reputed company on whole-person health by addressing the physical, emotional and reputed company wellness of our patients. As part of reputed company. (NYSE: HUM), reputed company offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly reputed company more than 30,000 clinicians who are committed to putting reputed company – for our teammates, patients, communities and company. By providing flexible scheduling reputed company, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and reputed company reputed company-being, reputed company from day one.​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply tot his job