- Appcast (Randallstown, MD)
- Utilization Review Nurse RN Randallstown, MD NORTHWEST HOSPITAL NW CARE MANAGEMENT Full-time - Day shift - 8:00am-4:30pm RN Other 92327 $38.20-$59.21 Experience ... system that values bold ideas and community-centered care. The Utilization Review Nurse RN conducts initial, concurrent...potential and actual denials and coordinates with nurse Care Manager and/or Social Worker for any follow up necessary.… more
- Legend Biotech USA, Inc. (Raritan, NJ)
- …MSAT, Facilities, C&Q, Project Management, and Quality.Work closely with Sr. Manager , Strategic Initiatives to support various strategic initiatives focusing on site ... of site operational models to better understand and assess resource utilization , equipment utilization , change impact, etc.Support assessment of facility… more
- JobElephant (Bowling Green, OH)
- …for BGSU Firelands Events Management activities. This position acts as project manager for external clients to meet personalized event needs, including processing of ... client relationships, executing sales strategies, and ensuring optimal space utilization through targeted marketing and outreach efforts.Responsible for ensuring… more
- The Career Sphere (Los Angeles, CA)
- …clinical site? Supervise medical providers including providing timely performance feedback, review of peer review findings, performance evaluations, continuous ... policies and procedures? Work in conjunction and collaboratively with the Nurse Manager and Clinic Manager to establish effective efficient streamlined processes… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
- Virtua Health (Pennsauken, NJ)
- …UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to ... resource group and payers.Documentation* Appropriate and complete documentation of clinical review and denial management in the case management documentation system… more
- Behavioral Center of Michigan (Warren, MI)
- …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
- Dayton Children's Hospital (Dayton, OH)
- … TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical ... information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource...a resource to the physicians, collaborates with the Care Manager in the development and implementation of the plan… more
- State of Indiana (Indianapolis, IN)
- …role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the purpose of ... Utilization Management Manager Date Posted: Sep 26, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Hospital-Plymouth** is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management** and ... + CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management** This role is ideal for a… more
- Mayo Clinic (Rochester, MN)
- …workers, physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status ... to work well within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records, value based purchasing… more
- Penn Medicine (Philadelphia, PA)
- …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) ... Experience: * And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best… more
- Wellpath (Mckinney, TX)
- …make a difference** The Regional Care Manager (RCM) is responsible for utilization review , care coordination, and daily care management across multiple sites ... Nursing or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience +… more
- Ochsner Health (Lafayette, LA)
- …Registered Nurse license in state of practice. Preferred - Commission for Case Manager (CCM), Certified Professional Utilization Review (CPUR), Certified ... by the physician and applies hospital approved medical necessity criteria to review appropriate admissions and levels of care. Documents completed reviews in the… more
- Devereux Advanced Behavioral Health (Malvern, PA)
- …could be longer based on the presenting symptoms. Every day as an Admissions & Utilization Review Manager you will + Supervise overall operations of DCBHC ... can take your career to the next level. **Being an Admissions & Utilization Review (UR) Manager Devereux Children's Behavior Health Center has its… more
- Nuvance Health (Sharon, CT)
- …to restore health to the patient. Responsibilities for this full time RN Case Manager position includes include utilization review , discharge planning and ... care transitions. Candidates require a CT state RN license, Bachelors Degree in Nursing or related field, a minimum of 1 year Case Management experience in an acute care setting. CCM, PRI and Screen certifications preferred. Mon thru Fri 8a-430p, Every other… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... collaboration with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more