• Denial Resource Center

    Baylor Scott & White Health (Dallas, TX)
    …experience. **Job Summary** You, as a Registered Nurse in the Denial Resource Center at Baylor Scott & White Health, manage denials and appeals. Your ... enhancement and earnestly participating in their implementation. + By closely examining denial trends, you will categorize them based on impacts like diagnosis, type… more
    Baylor Scott & White Health (05/15/25)
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  • Registered Nurse ( RN ) Case…

    Bon Secours Mercy Health (Portsmouth, VA)
    …for clinical and operational excellence. **Primary Function/General Purpose of Position** The RN Care Manager is responsible for providing coordination of care for ... the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods),...of active Case Management services and promotes the right resources , at the right time and at the right… more
    Bon Secours Mercy Health (05/19/25)
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  • Registered Nurse ( RN ) Case…

    Bon Secours Mercy Health (Midlothian, VA)
    …weekends per month (Saturday & Sunday) & week day availability is required** The RN Care Manager is responsible for providing coordination of care for patients to ... the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods),...of active Case Management services and promotes the right resources , at the right time and at the right… more
    Bon Secours Mercy Health (03/21/25)
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  • Social Worker or Registered Nurse

    Roper St. Francis (Mount Pleasant, SC)
    …Days (United States of America) **This position can be filled by either an RN Case Manager or an Social Woker** **Case Manager. See below for requirements for ... will reflect plan of care to address post hospital care needs and resources and evidence of patient, family, or caregiver involvement in planning. Ensuring patient's… more
    Roper St. Francis (04/25/25)
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  • Ops Registered Nurse

    MyFlorida (West Palm Beach, FL)
    OPS REGISTERED NURSE - 67915013 Date: May 8, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Requisition No: 852798 Agency: Agency for Persons with Disabilities Working Title: OPS REGISTERED NURSE - 67915013 Pay Plan: Health Care Practice Position… more
    MyFlorida (05/10/25)
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  • Access Center RN

    UCHealth (Aurora, CO)
    …Preferred: Bachelor's degree in Nursing. Required Licensure/Certification: State licensure as a Registered Nurse ( RN ). Basic Life Support (BLS) Healthcare ... appropriate action. Requirements: + Credentials: Essential: * Basic Life Support * Registered Nurse + Other information: Minimum Required Education: Graduate of… more
    UCHealth (03/26/25)
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  • Case Manager ( RN ) - Full Time…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager (CM) position is a registered nurse ( RN ) responsible for comprehensively planning for case management, which includes ... clinical experience + Case management experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or… more
    Houston Methodist (05/16/25)
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  • Case Manager RN Inpatient Rehabilitation…

    HCA Healthcare (Richmond, VA)
    …+ Graduate of an accredited school of nursing required, BSN preferred. + Current Registered Nurse license in Virginia or current Multistate Registered State ... **Introduction** Do you have the PRN career opportunities as a **Case Manager RN Inpatient Rehabilitation PRN** you want with your current employer? We have an… more
    HCA Healthcare (04/18/25)
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  • Revenue Integrity Clin Charge Review Analyst…

    HCA Healthcare (Richmond, VA)
    …reviews, and patient audits as needed. **Qualifications that you will need:** + Registered Nurse Degree required. + Minimum 1 year directly related Healthcare ... opportunities as a Revenue Integrity Clinical Charge Review Analyst RN you want with your current employer? We have...pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k)… more
    HCA Healthcare (03/22/25)
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  • RN , Case Manager (Part time), Forbes

    Highmark Health (Monroeville, PA)
    …also building relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care ... **Job Description :** At AHN, employees trust working together and place patients at the center of all they do. This 9 Hospital system, a part of Highmark Health, is… more
    Highmark Health (05/13/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Houston, TX)
    …be required to perform other duties as assigned. **Qualifications** **Required:** -Associate's Degree - Registered Nurse ( RN ) -Two (2) years of experience ... issues 3. Reviews all patient documentation in response to letters of denial for reimbursement. Assess individual situations and makes appropriate referrals to… more
    Catholic Health Initiatives (05/11/25)
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  • Prior Authorization Specialist - Inpatient Rehab…

    Select Medical (Scottsdale, AZ)
    …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... with Select Medical & HonorHealth Scottsdale, AZ **Prior Authorization Specialist - LPN or RN license** Fully Remote Position - MUST work 8:00am - 5:00pm schedule on… more
    Select Medical (05/23/25)
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  • Case Manager- RN

    WMCHealth (Poughkeepsie, NY)
    Case Manager- RN Company: MidHudson Regional Hospital City/State: Poughkeepsie, NY Category: Nursing/Nursing Management Department: Case Management Union: No ... link Job Details: JOB SUMMARY + The Case Manager assures timely, resource -effective transition planning, with respect for the patient and family as individuals… more
    WMCHealth (03/20/25)
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  • RN /Case Manager-Inpatient-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** ** RN /Case Manager Mount Sinai West FT Days 8a-4p Inpatient** The Case Manager (CM) will be responsible for all aspects of case management for an ... the length of stay (LOS), improved efficiency, quality and resource utilization. Assignment will be by units/clinical areas of...or a minimum of 3-5 years? experience as a RN in an acute care setting. + Current NYS… more
    Mount Sinai Health System (05/08/25)
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  • RN /Case Manager-MSH-Case…

    Mount Sinai Health System (New York, NY)
    **Job Description** ** RN /Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... the length of stay (LOS), improved efficiency, quality and resource utilization. Assignment will be by units/clinical areas of...or a minimum of 3-5 years? experience as a RN in an acute care setting. **Licensing and Certification… more
    Mount Sinai Health System (04/15/25)
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  • RN - Transtion of Care/Readmission

    LifePoint Health (Hickory, NC)
    …management as prescribed in the initial Utilization Review Plan with regard to resources , appropriateness of care and adherence to a designated Geometric Length of ... Stay (GLOS) for each patient. COMPANY DESCRIPTION Frye Regional Medical Center , located in the beautiful foothills of North Carolina is a 355-bed acute care… more
    LifePoint Health (04/18/25)
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  • Professional Care Manager- Hillman Cancer…

    UPMC (Pittsburgh, PA)
    …required with 4-6 weeks of hire. UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act 34 *Current licensure either in ... **UPMC Passavant's Hillman Cancer Center is hiring a Full Time Professional Care...preferred. **Licensure, Certifications, and Clearances:** Current licensure as a Registered Professional Nurse either in the state… more
    UPMC (05/08/25)
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  • Utilization Review Nurse (Position works…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry and ... financial targets, with a focus on appropriate utilization and denial prevention. Utilizes resources with cost effectiveness...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (05/15/25)
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  • Assistant Director of Case Management/Utilization…

    Mount Sinai Health System (New York, NY)
    …degree preferred + 5 years of Case Management and 6 years as a clinical nurse . + Previous supervisory experience in case management or a related field. + Name: ... development plans, continuing education and performance appraisal. 3. Manages resource use (staff/supplies) and directs expense and revenue decisions. Monitors… more
    Mount Sinai Health System (04/04/25)
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  • Utilization Review Nurse Supervisor I

    The County of Los Angeles (Los Angeles, CA)
    …or Medical Service Coordinator, CCS.** -OR- OPTION II: Two (2) years of experience as a registered nurse , of which one year must be in the treatment of chronic ... + A current, active license to practice as a Registered Nurse issued by the California Board...be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case… more
    The County of Los Angeles (05/22/25)
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