- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... State Licensure And/or Compact State Licensure Upon Hire Required + CNS-Clinical Nurse Specialist Preferred **Experience:** 5 years Clinical nursing experience.… more
- Cleveland Clinic (Cleveland, OH)
- …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...of Nursing + Current state licensure as a Registered Nurse (RN) + Basic Life Support (BLS) Certification through… more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for...extended stays, identifying opportunities for process improvements to enhance utilization management . + Serves as a key… more
- Corewell Health (Caledonia, MI)
- …and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and ... provides financial and utilization management (UM) information to other members...multiple clinical settings, or related experience Required + Registered Nurse (RN) - State of Michigan required How Corewell… more
- UNC Health Care (Kinston, NC)
- …applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 ... support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established… more
- Sharp HealthCare (San Diego, CA)
- …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
- Ascension Health (Austin, TX)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday, Days + **Location:** Remote + **Pay:** $93,857 - $126,983 + Eligible for ... assist with the budgeting process. + Serve as content specialist for staff in the areas of utilization...years of related experience is required. **Additional Preferences** + Utilization management experience strongly preferred. **Why Join… more
- PeaceHealth (Bellingham, WA)
- … Nurse in state of practice + Preferred: Psychiatric/Mental Health Clinical Nurse Specialist **Skills** + Strong psychiatric nursing background. (Required) + ... **Description** PeaceHealth is seeking a RN Admissions/ Utilization Behavioral Health - Care Management for a Full Time, 1.00 FTE, Day position. The salary range… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... financial, and utilization goals through effective management , communication, and...appropriate * Collaborates with department director and professional development specialist to develop standard work and expectations for the… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST OPS - 60955263 Date: Nov 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 862161 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST OPS - 60955263 Pay Plan:...Ability to analyze complex reports and determine the service utilization habits of clients and to evaluate the appropriateness… more
- Rush University Medical Center (Chicago, IL)
- …an integrated role of practice, education, administration and research. The Clinical Nurse Specialist exemplifies the Rush mission, vision, and values and ... Nurse licensure required. 2. Current state of Illinois Advanced Practice Nurse - Certified Clinical Nurse Specialist licensure required. 3. Graduate… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST - 60042416 Date: Dec 3, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 861824 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST - 60042416 Pay Plan: Career...knowledgeable of and utilize the principles of Total Quality Management . Nursing will provide guidance in the care and… more
- Northwell Health (Sleepy Hollow, NY)
- …and transfer of patients to the facility. Job Responsibility + Promotes optimum utilization of hospital beds; conducts rounds and meets with staff regarding bed ... is complete, and ensures hand-off of communication to accepting nurse . + Ensures beds are assigned based on level...of technical experience and 0-2 years of leadership / management experience, required. *Additional Salary Detail The salary range… more
- Immigration and Customs Enforcement (Washington, DC)
- …IHSC Medical Quality Management Unit. SUPERVISORY CONTROLS: The Clinical Senior Nurse Specialist , Medical Asset Support Team (MAST) member works under the ... clinical and administrative nursing support, and collaborating with the IHSC Chief Nurse in the Nursing Services Unit to implement initiatives aimed at enhancing… more
- UPMC (Harrisburg, PA)
- …the most specialized and rewarding areas of pediatric medicine. Purpose: The Programmatic Nurse Specialist , a professional registered nurse , has the ... the nursing process. In collaboration with the health care team, the Programmatic Nurse Specialist applies expert clinical knowledge and skills to achieve… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by ... the key performance indicators and quality measures, the RN specialist also aims to foster a culture of safety...AND ABILITIES REQUIRED** 1. RN with experience in risk management , quality assessment, or utilization management… more
- Cedars-Sinai (Los Angeles, CA)
- …Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review, Coding, or Case Management required Working knowledge of Joint ... Are you ready to bring your advanced Health Information Management skills to a world-class facility recognized as one...Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8… more
- AccentCare, Inc. (Austin, TX)
- …as needed, etc. + Reporting and management of case management model with focus on paraprofessional utilization - including correct ... Overview Clinical Support Specialist LVN LPN Location: Austin South Office Position:...Responsibilities: + Daily completion of the following tasks: daily management of KPIs, field staff support, verbal orders, workflow,… more
- BayCare Health System (Tampa, FL)
- …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...Call:** No **Certifications and Licensures:** + Required RN (Registered Nurse ) + Preferred ACM (Case Management ) +… more
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