- 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
- 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
- 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
- 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
- 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
- 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
- Ethos Risk Services (Houston, TX)
- …relationships, specifically within the medical management sector ( nurse case management , IME, utilization review , and medical bill review ). ... and/or liability. Preferred: Experience in B2B sales within nurse case management , IME, utilization review , and medical bill review . Familiarity with… 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
- 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 (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
- NavitsPartners (Boston, MA)
- …or case management role Demonstrated experience in discharge planning and utilization review within the past 4 years Working knowledge of InterQual(R) ... Job Title: Travel - Registered Nurse (RN) - Case Management Location:...or equivalent clinical review system Case Management certification (CCM, CPUM,… more
- Mount Sinai Hospital (New York, NY)
- Job Description Job Title - Nurse Practitioner- Cardiothoracic Stepdown Unit - Mount Sinai Hospital - Full Time - Split Shift A nurse practitioner (NP) as ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- SUNSHINE ENTERPRISE USA LLC (Orange, CA)
- …Preferably in the following related areas of responsibility: Grievances and Appeals, Utilization Management and/or Quality Management . An equivalent ... Job Description Grievance & Appeals Nurse Specialist At Sunshine Enterprise USA, we're not just a company; we're a community of dedicated professionals committed to… more
