- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Commonwealth Care Alliance (Boston, MA)
- …responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Specialist + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Care ... + Req #:42522-31559 + FTE:1 + Posted:July 18, 2025 **Summary** **SUMMARY:** The System Utilization Management (SUM) Care Without Delay RN is a pivotal role… more
- Houston Methodist (Sugar Land, 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
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... in an acute care setting. Required 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact… more
- Mount Sinai Health System (New York, NY)
- …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
- Sanford Health (Bemidji, MN)
- …minimum of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently ... written/verbal communication, critical thinking, creative problem solving, and conflict management skills. Must be proficient in organization and planning. Must… more
- LifePoint Health (Louisburg, NC)
- …job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* **Requisition ... Registered Nurse (RN) Utilization Review Job Type:...of those we serve. Connect with our RN recruiting specialist . Do you need more time to complete an… more
- Nuvance Health (Danbury, CT)
- …(2nd week) ; rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary ... of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level medical necessity reviews… more
- MyFlorida (Macclenny, FL)
- REGISTERED NURSE SPECIALIST - 60043220 Date: Jul 23, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 857220 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST - 60043220 Pay Plan: Career...Ability to analyze complex reports and determine the service utilization habits of clients and to evaluate the appropriateness… more
- MyFlorida (Marianna, FL)
- REGISTERED NURSE SPECIALIST - 67039438 (SUNLAND NURSING - ALL SHIFTS) Date: Jul 29, 2025 The State Personnel System is an E-Verify employer. For more information ... Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - 67039438 (SUNLAND NURSING -...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- MyFlorida (Clearwater, FL)
- 68064615 - REGISTERED NURSE SPECIALIST Date: Jul 23, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... for Health Care Administration Working Title: 68064615 - REGISTERED NURSE SPECIALIST Pay Plan: Career Service Position...individual, team member or team leader. As assigned by management , this position is required to successfully complete the… 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 ... veteran status, and other legally protected characteristics. **Position** Clinical Nurse Specialist , Neuro & Surgical IMCUs **Location** US:IL:Chicago… more
- WelbeHealth (Los Angeles, CA)
- …with better quality and compassion in a value-based model, and the Travel Registered Nurse (RN) Specialist directly guides this care as a primary voice on ... the interdisciplinary team (IDT). The Travel RN Specialist covers any nursing roles (eg, RN Case Manager,...any nursing roles (eg, RN Case Manager, RN Clinic Nurse ) as needed in multiple markets. The Travel RN… more
- Cambridge Health Alliance (Cambridge, MA)
- Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry **Requisition Number:** CHAP-2270 **Cambridge Health Alliance (CHA)** , a well-respected, ... is required authorizing practice in an expanded role as a Psychiatric Nurse Clinical Specialist and authorization including prescriptive authority. _In keeping… 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
- Amergis (Rancho Cordova, CA)
- …Week Amergis Healthcare is currently looking for qualified RN's with experience in Utilization Management . Apply today to learn more about the current ... opportunities! The Utilization Review Specialist is responsible for theassessment...+ Current license for the state in which the nurse practicesif nursing licensure is required by contract +… more
- AdventHealth (Orlando, FL)
- …ROLLINS STREET, Orlando, 32803 **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in partnership with ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...high risk for readmission or for high emergency room utilization . Follows up with patients at location of post… more
- Roper St. Francis (Charleston, SC)
- …partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based ... for professional actions * Effective stewardship of available resources * Conflict management and resilience * Authority for delegating activities to others, while… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the ... with clinical team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make… more
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