- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, ... in Utilization Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six years of clinical… more
- Veterans Affairs, Veterans Health Administration (Los Angeles, CA)
- …is seeking to hire experienced Registered Nurses to work in our Utilization Management (UM) Program. Incumbents are expected to perform assessing, planning, ... following: Demonstrates ability to perform a wide range of Utilization Management /Quality Management /Performance Improvement (UM/QM/PI)...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- McLaren Health Care (Pontiac, MI)
- …12. Performs other duties as assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited educational ... requirements _Preferred:_ + Bachelor's degree in nursing + Experience in utilization management /case management /clinical documentation, critical care, or… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- CareOregon (Portland, OR)
- …Reports Registered Nurse - Clinical Quality Assurance, Registered Nurse - Utilization Management II Manager Title Director, Quality Assurance - ... correct and effective use of decision tools used for utilization management activities including staff training. The...as needed. Experience and/or Education Required + Current unrestricted Registered Nurse (RN) license for State of… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
- CDPHP (Albany, NY)
- …Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York… more
- Actalent (Santa Barbara, CA)
- Job Title: Health Plan Nurse Coordinator Non-profit healthcare network is looking for a utilization management registered nurse to join their team on ... REQUIREMENTS: + CA RN license + Medi-Cal Experience + Utilization Management WHAT'S IN IT FOR YOU:...Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one… more
- AdventHealth (Glendale Heights, IL)
- …Heights, IL 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable...capacity to prioritize multiple tasks and role components. + Registered Nurse (RN) Required + Accredited Case… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …Revenue, Billing, Insurance Verification, Veteran Services, Compliance, Providers, Health Information Management (HIM), Utilization Management (UM), and ... Summary The Revenue Utilization Review (RUR) nurse is under...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- LifePoint Health (Louisburg, NC)
- …select a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review Coordinator* **Location:** ... Registered Nurse (RN) Utilization ... Registered Nurse (RN) Utilization Review Job Type:...days for patients. - Maintaining communication with the Case Management Department to facilitate timely discharge planning.. Reports to:… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Facility:** St. Agnes ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification… more
- Intermountain Health (Murray, UT)
- …regarding authorizations, approved treatment plan and length of stay. **Skills** + Utilization Management + Clinical Expertise + Independent and autonomous + ... in care management /navigation or closely related field including: Utilization Management , discharge planning, managed care, health promotion, health… more
- The County of Los Angeles (Los Angeles, CA)
- …ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...County of Los Angeles, a Utilization Review Nurse is an RN that has Case Management… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding ... Collaborates with the multidisciplinary team to assess and improve the denial management , documentation, and appeals process. + Collaborates with UR Manager and/or… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Cottingham...20250804 Featured Job TH Ad TH Comments **Similar Jobs** Registered Nurse (RN) Senior Care MercyOne RN ... 1 Positions ID: 4627707008 Posted On 07/01/2025 **Job Overview** ** Utilization Management Nurse ** **Location** :...- Float Pool Registered Nurse … more
- 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 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity ... Oncology, and/or elective surgical cases preferred. Essential Qualifications * Current licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN)… more
- CVS Health (Harrisburg, PA)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and… more