- EXL Service (Albuquerque, NM)
- …the right treatment to the right patient at the right time. Utilization Management & Complex Case Manager, Registered Nurse This is a remote, telephonic ... need? Join our team as a Utilization Management & Complex Case Management Nurse...in Hospital Acute Care, Prior Auth, Utilization Review / Utilization Management and… more
- University of Iowa Hospitals & Clinics (Iowa City, IA)
- …of Iowa Healthcare University Campus, within the Continuum of Care Division, Utilization Management Team is looking for a Nurse Clinician to functions as a ... regarding the compliance portion of the level of care. Review data specific to utilization management...procedures and processes to continually improve utilization review operations. Work collaboratively with Nurse Navigators… more
- J Edward Staffing LLC (Aurora, CO)
- NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,600 - ... Experience: *36+ months RN experience in direct patient care *12 consecutive months in Utilization Management , Utilization Review , or Case Management… more
- Medical Solutions (Omaha, NE)
- …CA is seeking its next amazing RN (Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this sounds like your perfect fit! ... Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone… more
- Connecticut Children's (Hartford, CT)
- …Preferred: Experience: Pediatric nursing experience Previous experience in Utilization Review Previous experience in Case Management or Discharge planning ... Job Description The Team Lead for Utilization Review (UR) is responsible for...regarding appropriate utilization of resources. -5% Represents Utilization Management at various committees, as needed.… more
- The University of Kansas Health System (Kansas City, KS)
- Position Title Access Case Manager - Utilization Review (Evergreen) Sudler Position Summary / Career Interest: **Part Time Weekend Shift Available** The Access ... Case Manager (CM), under the direction of the Director/Manager of Case Management functions as a member of the interdisciplinary healthcare team in the provision of… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Three years recent, broad clinical experience in the hospital setting Experience with utilization management within the last 3 years required An understanding of ... care using Interqual criteria. Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to… more
- Geisinger (Wilkes Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Location: Wilkes-Barre, Pennsylvania Job Category: Inpatient RN - Registered ... Nurse , Nursing and Nursing Support Schedule: Rotation Work Type:...Support Schedule: Rotation Work Type: Full time Department: Talent Management Nursing & Nursing Support Team Date Posted: 04/29/2025… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton) Location: Scranton, Pennsylvania Job Category: Inpatient RN - Registered ... Nurse , Nursing and Nursing Support Schedule: Rotation Work Type:...Support Schedule: Rotation Work Type: Full time Department: Talent Management Nursing & Nursing Support Team Date Posted: 04/29/2025… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse (RN) with a ... (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management . Strong working knowledge of hospital billing,… more
- UofL Health (Louisville, KY)
- …care. The Utilization Review RN performs activities which support the Utilization Management functions. They are responsible for the delivery of the ... each and every day. Job Description: We are Hiring Utilization Review RNs at Peace Hospital Location:...license with privileges to work in Kentucky Certification: *Case Management Certification (ACM, ANCC- Nurse Case Manager or… more
- Temple University (Philadelphia, PA)
- …from qualification visits to close-out visits. The position will require knowledge and utilization of various systems for clinical trial management . Grade: T26 ... Clinical Research Nurse Manager The Lewis Katz School of Medicine...IRB submissions and follow-ups; and overseeing data collection and management in accordance with trial protocol. Perform nursing assessments… more
- Strategic Staffing Solutions (Detroit, MI)
- …Must have Medicare Advantage experience working for a health insurance provider. Utilization Management experience is a plus. Engagement Description: We are ... (S3) HAS AN OPENING! Strategic Staffing Solutions is currently looking for a Registered Nurse for one of our largest clients in Detroit, MI! Job Title: Registered … more
- University Hospitals (Beachwood, OH)
- …acute care setting (Required) and 3+ years Of experience in managed care or utilization review (Preferred) and Experience and training on Interqual or MCG ... communication, awareness and adherence to regulatory requirements associated with utilization *Support for inappropriate level of care and decreased inpatient… more
- Baptist Health Care (Gulf Breeze, FL)
- …improvement and evaluation processes related to the management of patient care. The Utilization Review Nurse is on-site and available seven days a week, ... Job Description The Utilization Review Nurse acts...hospitalization and discharge planning. Maintains current knowledge of case management , utilization management , and discharge… more
- Geisinger (Bellefonte, PA)
- …Schedule: Days Work Type: Full time Department: Community Medicine Licensed Practical Nurse Team Date Posted: 07/18/2025 Job ID: R-75160 Job Summary Geisinger is ... reason for visit, weight, vital signs, visit screening information, medication review , and pertinent information for provider. Sets up examination and treatment… more
- MediTelecare (Bedford, NH)
- …writing orders for medications, as appropriate Participate in case reviews, consultations and utilization review Respond to urgent calls from the facility and ... healthcare services to underserved communities as a Psychiatric Mental Health Nurse Practitioner (PMHNP) with MediTelecare, the nation's largest telehealth company!… more
- Geisinger (Bellefonte, PA)
- …Schedule: Days Work Type: Full time Department: Community Medicine Licensed Practical Nurse Team Date Posted: 05/22/2025 Job ID: R-77177 Job Summary $3,000 for ... reason for visit, weight, vital signs, visit screening information, medication review , and pertinent information for provider. Sets up examination and treatment… more
- Geisinger (Wilkes Barre, PA)
- …Support Schedule: Days Work Type: Full time Department: Northeast Licensed Practical Nurse Team Date Posted: 06/20/2025 Job ID: R-74816 Job Summary clerical support ... reason for visit, weight, vital signs, visit screening information, medication review , and pertinent information for provider. Sets up examination and treatment… more
- Atlantic Health System (Basking Ridge, NJ)
- Job Description Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work 4PM to 2AM / 4 days per week in ... responsible for managing a heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to provide each patient with the… more
