• CHRISTUS Health (San Antonio, TX)
    …for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
    Talent (09/24/25)
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  • CHRISTUS Health (Tyler, TX)
    DescriptionSummary: The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and wellness ... and other providers. Incumbent oversees integrated data warehouse including program utilization , disease management programs and contracted provider network… more
    Talent (09/15/25)
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  • Skaggs Community Hospital Association (Branson, MO)
    …and utilization of Aseptic Technique. Licensure/Certification/Registration: ▪ Required:Missouri State Registered Nurse AND Certified as a Registered ... and utilization of Aseptic Technique. ◦ Licensure/Certification/Registration ▪ Required:Missouri State Registered Nurse AND Certified as a Registered more
    Talent (10/08/25)
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  • Utilization Management

    Crouse Hospital (Syracuse, NY)
    …health education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and ... Sign-On Bonus! Schedule: Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse (RN) Position Responsibilities: +… more
    Crouse Hospital (09/25/25)
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  • Utilization Management

    AdventHealth (Daytona Beach, FL)
    …Daytona Beach, 32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable...+ Current and valid license to practice as a Registered Nurse (ADN or BSN) required. +… more
    AdventHealth (09/18/25)
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  • ED Utilization Management

    AdventHealth (Tampa, FL)
    …**The ro** **le you'll contribute:** The role of the Emergency Department Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise ... for additional review as determined by department standards. The Utilization Management Nurse is accountable...records of at least two years Preferred RN - Registered Nurse - State Licensure and/or Compact… more
    AdventHealth (10/11/25)
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  • Registered Nurse

    ERP International (Vandenberg AFB, CA)
    **Overview** ERP International is seeking a full-time ** Registered Nurse (RN) Utilization Management ** for a temporary contract position in support of ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
    ERP International (09/13/25)
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  • Clinical Registered Nurse

    Cognizant (Carson City, NV)
    …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (10/07/25)
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  • Registered Nurse (RN)…

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA… more
    Commonwealth Care Alliance (10/02/25)
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  • RN Utilization Management - Acute…

    Trinity Health (Albany, NY)
    …NY** is looking for an experienced RN to work as a Registered Professional Utilization Management Nurse (UMRN) per diem. The team is willing to help ... **Employment Type:** Part time **Shift:** Day Shift **Description:** **RN for Utilization Management - Per Diem** **St. Peter's Hospital in Albany,… more
    Trinity Health (10/07/25)
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  • Director of Case Management and Logistics

    Bassett Healthcare (Cooperstown, NY)
    …of experience in Case Management , discharge planning, and/or Utilization Management Licensure/Certifications: + Registered Nurse or LMSW or eligible ... the department. Oversees and works with the Director of Utilization Management to support and implement the...well as state and federal regulations.* Collaboration: Partner with nurse managers, nursing directors, and other leaders across the… more
    Bassett Healthcare (10/09/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Sacramento, CA)
    …degree and 4+ years of related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...with all policies and standards **Candidates must have a Registered Nurse (RN) license for California and… more
    Centene Corporation (10/08/25)
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  • Registered Nurse (RN) Case Manager…

    Ochsner Health (New Orleans, LA)
    …develop and implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson Highway PRN ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
    Ochsner Health (07/30/25)
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  • RN Utilization Management

    Trinity Health (Albany, NY)
    …often lead to innovative solutions. ** Registered Nurse Professional Utilization Management Nurse - St. Peter's Hospital--Full-TIme Days** If ... to accommodate all schedules **What you will do:** + Perform utilization management , both concurrent and retroactive for inpatient and outpatient services in… more
    Trinity Health (09/30/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per ... Diem Registered Nurse II/III - Utilization Management VCMC Salary $109,727.64 - $184,627.89 Annually Location Ventura and Santa Paula, CA Job Type… more
    Ventura County (09/27/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually Location Ventura and Santa Paula, CA Job Type Full-Time… more
    Ventura County (09/21/25)
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  • RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    Summary The Registered Nurse (RN) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, ... coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer...of patient status. 1. Collaborate and set standards with registered nurse (RN) case managers (CMs) and… more
    Guthrie (10/04/25)
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  • Registered Nurse

    Beth Israel Lahey Health (Boston, MA)
    …and Responsibilities:** 1, Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate ... payer certification, and denied cases. 6. Monitors effectiveness/outcomes of the utilization management program, identifying and applying appropriate metrics,… more
    Beth Israel Lahey Health (09/10/25)
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  • Utilization Review Analyst…

    Beth Israel Lahey Health (Burlington, MA)
    …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
    Beth Israel Lahey Health (10/02/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management more
    The County of Los Angeles (10/06/25)
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