• Utilization Review Case

    Trinity Health (Mason City, IA)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **JOB SUMMARY:** The Utilization Review Case Manager responsibilities include case ... with documentation standards, policies, procedures and/or guidelines **Minimum Qualifications:** + Licensed registered nurse in the state of Iowa. + Bachelor's… more
    Trinity Health (04/19/25)
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  • Case Manager Utilization

    Beth Israel Lahey Health (Burlington, MA)
    …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse ( RN ) Case...a timely process. Registered Nurses (RNs) with utilization review experience, case management… more
    Beth Israel Lahey Health (04/16/25)
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  • RN - Utilization Review - HS…

    Baptist Memorial (Jackson, MS)
    …referral program Job Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - Hospital Department: HS Case Mgmt Administration Corporate ... Overview  Summary The Utilization Review Nurse is...against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of… more
    Baptist Memorial (02/17/25)
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  • Utilization Review Case

    Trinity Health (Lavonia, GA)
    **Employment Type:** Full time **Shift:** **Description:** The RN Case Manager ( RN CM), works in collaboration with a multidisciplinary team by identifying ... care throughout hospitalization in compliance with CMS and organizational utilization management requirements. RN CM helps to ensure medical necessity is met by… more
    Trinity Health (03/08/25)
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  • Utilization Review Nurse

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse ( RN ) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse ( RN...Holidays (Outlined in Handbook) + 401(k) Plan Minimum Requirements Registered Nurse ( RN ) Utilization more
    Matrix Providers (04/29/25)
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  • Manager, Utilization Management/…

    CoreCivic (Brentwood, TN)
    …- $97,400 with a 10% bonus eligible._ **SUMMARY:** The Manager, Utilization Management/ Case Management provides Utilization Review and Case ... and approving leave requests. + Collaborates with management for oversight of the utilization review process to ensure services being rendered are appropriate… more
    CoreCivic (04/29/25)
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  • Registered Nurse

    Aspen Medical (Aurora, CO)
    JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... care clinical setting. Must have utilization management, utilization review or case management...full, active, and unrestricted license to practice as a Registered Nurse as required in the TO… more
    Aspen Medical (04/23/25)
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  • Utilization Reviewer RN

    Monroe Plan for Medical Care (Albany, NY)
    …to work independently.-Strong organizational skills.-Strong computer and typing skills PREFERRED: -Prior Utilization Review or Case Management preferred. ... Utilization Reviewer RN Summary Title: Utilization...REPORTS:NoESSENTIAL JOB DUTIES/FUNCTIONS % of Time Essential Function 75 Utilization Review Functions Perform utilization more
    Monroe Plan for Medical Care (04/18/25)
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  • Corporate Director of Clinical Utilization

    Prime Healthcare (Ontario, CA)
    …strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with facility-based case ... A minimum of seven (7) years' experience in Clinical Utilization Review or Case Management...with a large Health Plan + An active CA Registered Nurse license + Current BCLS (AHA)… more
    Prime Healthcare (04/17/25)
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  • Program Mgr UR/ Case Management - CMC…

    UTMB Health (Friendswood, TX)
    …a safe and efficient work environment. + Monitors the work performance of the Utilization Review Case Management staff and provides guidance as necessary. ... nursing. + Provides assistance with clinical issues for non-nursing Utilization Review Case Management staff....Professional Nursing + Current Texas Nursing Licensure as a Registered Nurse ( RN ). + Minimum… more
    UTMB Health (04/04/25)
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  • Registered Nurse Case Manager…

    Henry Ford Health System (Detroit, MI)
    …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
    Henry Ford Health System (04/10/25)
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  • Registered Nurse - Plan Case

    PruittHealth (Norcross, GA)
    …Minimum three years industry experience in a managed care setting focused on experience in utilization review / case management and at least two years case ... with long-term care population **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** * Licensed Registered Nurse with current, unrestricted license in state of… more
    PruittHealth (04/04/25)
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  • Registered Nurse ( RN

    LifePoint Health (Warrenton, VA)
    …by applicable federal, state or local law./ **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN ) Case Manager* **Location:** ... Sign On Bonus for experienced candidates (new hires)* The RN Case Manager monitors and manages patient...*Required*- Three years of nursing experience. *Preferred*- Experience in utilization review , case management, discharge… more
    LifePoint Health (01/31/25)
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  • Registered Nurse Case Manager…

    HCA Healthcare (Derry, NH)
    …set us apart from any other healthcare provider. We are seeking a Registered Nurse Case Manager RN to join our healthcare family. **Benefits** Parkland ... patient care. Apply today for our Registered Nurse Case Manager RN opportunity.... Case Manager's primary duties are to provide Utilization Review and Case Management… more
    HCA Healthcare (02/22/25)
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  • RN Case Manager Registered

    HCA Healthcare (Derry, NH)
    …growth, we encourage you to apply for our RN Case Manager Registered Nurse PRN opening. We review all applications. Qualified candidates will be ... the PRN career opportunities as a(an) RN Case Manager Registered Nurse PRN... Case Manager's primary duties are to provide Utilization Review and Case Management… more
    HCA Healthcare (04/10/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …for appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for...Case Manager include, but are not limited to, utilization review , case management, care… more
    Ellis Medicine (04/25/25)
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  • Acute Nurse Case Manager ( RN

    ChenMed (St. Louis, MO)
    RN with Bachelor Degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + A minimum ... practice. Job duties/responsibilities that are performed by either the RN or LPN include: + Conducts utilization ...experience required + A minimum of 1 year of utilization review and/or case management,… more
    ChenMed (03/25/25)
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  • RN Case Manager - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or social work ... RN Case Manager - Full Time... RN Case Manager - Full Time - Days Department:...filed. + Bachelor's degree is preferred. + Licensed professional nurse may be considered. + Bachelors or Masters Degree… more
    Mohawk Valley Health System (04/16/25)
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  • Case Management Assistant

    University of Utah Health (Salt Lake City, UT)
    …education in healthcare or a related field. + One year of experience in a utilization review or case management environment. + Basic Life Support Health ... coordination of care activities under the direction of a registered nurse and/or social worker. The incumbent...discharge plans prepared and delegated by social work or nurse case management by coordinating with home… more
    University of Utah Health (03/26/25)
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  • Registered Nurse Case

    Hackensack Meridian Health (Maywood, NJ)
    …concurrent patient management. + Knowledge of health care delivery system, utilization and review and case review procedures. + Good working knowledge of ... and serve as a leader of positive change. The ** Registered Nurse Care Manager** is a member...facility Coordination and handoff between acute & post-acute services. RN Case Manager is for Child and… more
    Hackensack Meridian Health (04/22/25)
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