• RN Utilization Review - Case

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a ... Registered Nurse with us, you'll have the...This position integrates national standards for case management scope of services including: Utilization more
    Tenet Healthcare (12/03/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Specialist Nurse

    Houston Methodist (Houston, TX)
    …experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered ... Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively...state, local, and federal programs + Comprehensive knowledge of utilization management , case management more
    Houston Methodist (11/02/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse

    McLaren Health Care (Bay City, MI)
    …duties as required and directed. #LI-LM1 **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... experience with an acute care hospital** _Preferred:_ + Experience in utilization management / case management , critical care, clinical documentation, or… more
    McLaren Health Care (11/22/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Utilization

    McLaren Health Care (Port Huron, MI)
    …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... experience with an acute care hospital **Preferred:** ⦁ Experience in utilization management / case management , critical care, clinical documentation, or… more
    McLaren Health Care (11/12/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Admissions…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Utilization Management (UM) Admissions Liaison RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (10/03/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Case

    WellSpan Health (Lebanon, PA)
    …PM Includes Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most ... patient discharge needs. Provides leadership in the integration of utilization and case management principles...., or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or +… more
    WellSpan Health (11/15/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager- Registered

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management , ... experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...and federal programs + Progressive knowledge of discharge planning, utilization management , case management more
    Houston Methodist (11/15/25)
    - Save Job - Related Jobs - Block Source
  • Nursing RN Case Management

    Trinity Health (Troy, NY)
    …+ 2 years of experience in acute setting **Preferred requirements:** + 1+ year of experience in case management or utilization management + Case ... member of our caring, compassionate health care team the RN Case Manager will enjoy:** + Hours...Engage the patient and care team in the joint management of key patient outcomes such as management more
    Trinity Health (10/30/25)
    - Save Job - Related Jobs - Block Source
  • PRN Clinical Utilization Review Specialist

    Community Health Systems (Franklin, TN)
    …+ Documents all utilization review activities in the hospital's case management software, including clinical reviews, escalations, avoidable days, payer ... Nursing preferred + 2-4 years of clinical experience in utilization review, case management , or...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
    Community Health Systems (12/03/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Product Consultant - Utilization

    Waystar (Atlanta, GA)
    Management team in an acute care setting + Active and current Utilization and/or Case Management Certification + 2-3 years' experience with MCG ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of...best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as… more
    Waystar (11/21/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager - PRN

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management more
    Houston Methodist (11/07/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager Certified - Transition in Care

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse ( RN ) responsible for comprehensively planning for case ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...and federal programs + Comprehensive knowledge of discharge planning, utilization management , case management more
    Houston Methodist (10/11/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager Care Continuity Services…

    Truman Medical Centers (Kansas City, MO)
    …written **Preferred Qualifications:** + RN experience in hospital utilization review, utilization management , or case management **Why Join Us?** ... **Position Overview:** We are seeking a dedicated and detail-oriented Case Manager (CM)-a registered nurse ...role, you will identify patients who would benefit from case management services and coordinate care across… more
    Truman Medical Centers (10/01/25)
    - Save Job - Related Jobs - Block Source
  • 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 ...principles, practices, techniques and methods of utilization review/ management , discharge planning or case management more
    Ventura County (09/21/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The...+ Current license to practice as a Registered Nurse in the State of Utah,… more
    University of Utah Health (10/02/25)
    - Save Job - Related Jobs - Block Source
  • Quality/ Utilization Review Nurse

    George C. Grape Community Hospital (Hamburg, IA)
    …infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. * ... Quality/ Utilization Review Nurse Position Summary: The...nursing experience (acute care preferred). o Prior experience in utilization review, case management , quality… more
    George C. Grape Community Hospital (11/25/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health ... compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals,… more
    BriteLife Recovery (12/05/25)
    - Save Job - Related Jobs - Block Source
  • Social Worker - Case Manager

    Luke Staffing (Agana Heights, GU)
    …to Government and professional clinical standards and clinical protocols. . Participate in Utilization Management / Case Management meetings to review and ... services. . Provide patient referrals. Interface with the MTF RN Case Manager(s) in the development and... Manager(s) in the development and implementation of the Case Management Program (CMP). . Develop local… more
    Luke Staffing (11/13/25)
    - Save Job - Related Jobs - Block Source
  • Director Case Management

    Brockton Hospital (Brockton, MA)
    …while optimizing resource utilization . Provides training to staff on case management methods and techniques. Establishes monitoring mechanisms to identify ... and develops reports that clearly monitor all areas of utilization / case management . Provides data, guidance...RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts… more
    Brockton Hospital (09/12/25)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager - Emergency…

    Trinity Health (Philadelphia, PA)
    …nursing required. + Active PA RN License required. + Three (3) years of utilization management or case management experience, including emphasis on ... member of Trinity Health Mid-Atlantic, is seeking an experienced RN Care Manager to join our team in the...discharge planning. + Case Management certification from an accredited organization preferred **We offer… more
    Trinity Health (11/13/25)
    - Save Job - Related Jobs - Block Source