- GIBSON AREA HOSPITAL (Gibson City, IL)
- …Full Time Salary Range $32.00 - $48.00 Hourly Description JOB TITLE: UTILIZATION REVIEW / CASE MANAGEMENT - Nurse DEPARTMENT: CASE MANAGEMENT (QUALITY) ... GENERAL SUMMARY The Utilization Review / Case Management Nurse is directly...to interact with patients/families, healthcare providers, and outside agencies. Registered Nurse with at least two years… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …BLS - AHA Must-Have: Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient ... 09/08/2025 End Date 12/08/2025 Duration 13 Week(s) Job Description About the Position Specialty: RN Case Manager Experience: 1+ year of recent case … more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case Manager @ Providence Little Company of Mary Medical ... Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse ...discharge planning and utilize interqual criteria - Experience in utilization review and concurrent reviews Description: This… more
- PharmaCord (Jeffersonville, IN)
- …degree required; Master's degree is preferred Nurse line triage, Call Center Utilization Management, Call Center Case Management a plus Case management ... clearly and articulately Have a positive attitude! Education & Experience: Licensed Registered Nurse 2-3 years nursing with experience in rare disease,… more
- SR International, Inc. (Phoenix, AZ)
- …nursing practice, medical case management protocols, quality management and utilization review protocols as related to all populations including Maternal ... laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote/Onsite Trainings) Skills...AHCCCS program *Good written and communication skills *Computer skills * Utilization Review skills *Medical Claims Review… more
- UTMB Health (Galveston, TX)
- Utilization Review Case Mgr -...nursing and current Texas Nursing licensure as a professional registered nurse . Minimum of three years of full ... and criteria guidelines. **MAJOR DUTIES / CRITICAL TASKS:** + Implements Utilization review procedures by prospectively, concurrently, and retrospectively… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for promoting ... an expert level at all objectives delineated in the Utilization Review Nurse and ...case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- 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** ... case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review...+ Current license to practice as a Registered Nurse in the State of Utah,… more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management, or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...EHR and UR logs. + Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and… more
- HCA Healthcare (Houston, TX)
- …our nurses set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** ... their passion for patient care. Apply today for our Registered Nurse Case Manager opportunity....care experience required. Minimum of two (2) years of utilization review / case management experience and… more
- 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
- ChenMed (Hampton, VA)
- …promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The ... English. EDUCATION / SPECIALIZED KNOWLEDGE REQUIREMENTS: + Licensed professional nurse , RN , LPN, etc. + Minimum of...etc. + Minimum of seven (7) plus years of utilization review / case management. + Minimum… more
- 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
- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- Marshfield Clinic (Marshfield, WI)
- …Required:** Three years' experience in a medical facility. **Preferred/Optional:** Discharge Planning, Utilization Review or Case Management experience in a ... the most exciting missions in the world!** **Job Title:** RN Case Manager - Hospital **Cost Center:**...to the position._ **Minimum Required:** Current State of Wisconsin Registered Nurse license or Nurse … more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review , case and disease management processes, skill ... and Blue Shield of Minnesota Position Title: Care Advocacy Case Manager RN Location: Remote Career Area:...of care between settings. Required Skills and Experience * Registered nurse with current MN license and… more
- Mohawk Valley Health System (Utica, NY)
- RN - Case Manager - Full...Education/Experience Requirements Required: + Minimum of two (2) years utilization review / case management experience or ... Job Summary Reports to and is under direct supervision of Case Management Department. Provides ongoing support and expertise through comprehensive assessment,… more
- CVS Health (Baton Rouge, LA)
- …per our company expense reimbursement policy. **Preferred Qualifications** + Managed care/ utilization review experience + Case management experience ... facilities, hospitals, group homes, shelters, and community facilities. The Case Manager RN (CM RN )...in Orleans, Jefferson, St. Bernard or Plaquemines parishes. + Registered Nurse with current unrestricted Louisiana (LA)… more
- NJM Insurance (Parsippany, NJ)
- …with all statutory, regulatory, licensing requirements, and NJM policies/guidelines that affect utilization review , case management, and medical management. ... Reporting directly to the Medical Management Supervisor, the Workers' Compensation (WC) Case Manager supports the WC Department by following the best practices… more
- Ventura County (Ventura, CA)
- Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43...general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case… more
