• Appcast (Randallstown, MD)
    …activities as required by payor. Monitors and identifies patterns or trends in utilization management . Monitors potential and actual denials and coordinates with ... Utilization Review Nurse RN Randallstown, MD...advisors to review cases not met with criteria REQUIREMENTS: Registered Nurse License - Current Maryland license… more
    Talent (10/03/25)
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  • CHRISTUS Health (Arp, 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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  • CHRISTUS Health (Macdona, 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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  • Jooble (Alamogordo, NM)
    Description Summary: The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and ... and other providers. Incumbent oversees integrated data warehouse including program utilization , disease management programs and contracted provider network… more
    Talent (10/02/25)
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  • CoxHealth (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 (10/03/25)
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  • Daiichi Sankyo, Inc. (Phoenix, AZ)
    …a driving record that meets company requirements Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure The ideal ... strong, long-term relationships with clinical personnelEnsures appropriate and compliant utilization of product and disease state education as it...candidate will be a Registered Nurse with previous relevant clinical as… more
    HireLifeScience (09/23/25)
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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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  • 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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  • Registered Nurse

    ERP International (Barksdale AFB, LA)
    **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, ... in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical… more
    ERP International (09/17/25)
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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

    Wellpath (Fort Lauderdale, FL)
    …for training, education, and point of care support. **How you make a difference** The Utilization Management Registered Nurse works under the guidance of ... accordance with applicable state and local laws. Quick Apply (https://careers-wellpath.icims.com/jobs/181904/ utilization - management - registered - nurse -%28rn%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336175207) **Need help… more
    Wellpath (10/02/25)
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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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  • 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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  • 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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  • 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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  • Utilization Management

    McLaren Health Care (Flint, MI)
    We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
    McLaren Health Care (10/01/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (UT)
    …years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
    CVS Health (10/02/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
    CDPHP (09/23/25)
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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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