• Yale New Haven Health (Shelton, CT)
    …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... According To Unit Policies And Procedures. Provides Supervision Of Non- Rn Personnel On The Assigned Unit. When Assuming The...Care For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS… more
    JobLookup XML (12/18/25)
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  • Alameda Health System (Oakland, CA)
    …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance...Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
    job goal (12/08/25)
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  • Yale New Haven Health (New Haven, CT)
    …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required. more
    JobLookup XML (12/19/25)
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  • Yale New Haven Health (Bridgeport, CT)
    …Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse ( Rn ) Assesses, Plans, Implements, Evaluates And Supervises ... Regarding Care For Patients. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information… more
    JobLookup XML (12/18/25)
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  • Baptist Memorial Health (Southaven, MS)
    …and/or life situation. Performs other duties as assigned. Responsibilities Utilization Review Discharge planning Readmission Reduction Participation Payer ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...Hospital Department: DC Case Management Admin BMH Desoto Category: Nurse RN Type: Clinical Work Type: Full… more
    JobLookup XML (12/03/25)
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  • University Health (San Antonio, TX)
    …recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is preferred. ... clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF...of the State of Texas to practice as a registered nurse is required. National certification in… more
    job goal (12/15/25)
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  • University Health (San Antonio, TX)
    …recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. ... Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred....of the State of Texas to practice as a registered nurse is required. National certification in… more
    job goal (12/15/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
    The County of Los Angeles (10/06/25)
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  • Utilization Review Nurse

    State of Connecticut, Department of Administrative Services (Middletown, CT)
    …eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) ... Utilization Review Nurse Coordinator...(https://www.elicense.ct.gov/) online (expand the 'Public Health Practitioners' grouping, select ' Registered Nurse ' and then 'Start'; + Request… more
    State of Connecticut, Department of Administrative Services (12/12/25)
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  • Utilization Review Nurse

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    Utilization Review Nurse Coordinator (40...+ + + + Introduction Are you an experienced Registered Nurse looking to make a difference in ... to learn more about joining our team as a Utilization Review Nurse Coordinator! The...GENERAL EXPERIENCE Five (5) years of experience as a Registered Nurse . MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE… more
    State of Connecticut, Department of Administrative Services (12/17/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
    The County of Los Angeles (09/27/25)
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  • Quality/ Utilization Review

    George C. Grape Community Hospital (Hamburg, IA)
    Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. *… more
    George C. Grape Community Hospital (11/25/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
    Centene Corporation (12/05/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (09/23/25)
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  • Utilization Review Denials…

    UNC Health Care (Kinston, NC)
    …clinical experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience preferred. + Minimum 1 year ... to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying… more
    UNC Health Care (11/20/25)
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  • Utilization Review Specialist…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (11/02/25)
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  • Registered Nurse Utilization

    Catholic Health (Kenmore, NY)
    …Days with Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse ( RN ), Utilization Review , as an active member of the Middle ... in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with...facilitate movement of the patient through the continuum. The Utilization Review RN identifies and… more
    Catholic Health (12/17/25)
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  • Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... nursing*( RN ) experience or * 2 years of recent* utilization review , utilization management*nursing experience.../*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of… more
    Minnesota Visiting Nurse Agency (12/03/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (10/02/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
    US Tech Solutions (10/17/25)
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