- Christus Health (San Antonio, TX)
- …and operations for assigned areas; at CHRISTUS St. Patrick Hospital. The nurse manager affects departmental outcomes through interpretation, implementation, and ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Geisinger (Danville, PA)
- Job Title: RN-Registered Nurse -Advanced Acute Care Surgery The full job description covers all associated skills, previous experience, and any qualifications that ... to have. Location: Danville, Pennsylvania Job Category: Inpatient RN - Registered Nurse , Nursing and Nursing Support Schedule: Days Work Type: Full time Department:… more
- Geisinger (Wilkes Barre, PA)
- Job Title: LPN - Graduate Inpatient Licensed Practical Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Find out more about this role by reading the information below, ... be considered. Location: Wilkes-Barre, Pennsylvania Job Category: LPN - Licensed Practical Nurse , Nursing and Nursing Support Schedule: Rotation Work Type: Full time… more
- Geisinger (Scranton, PA)
- Job Title: LPN - Experienced Inpatient Licensed Practical Nurse (Geisinger Community Medical Center, Scranton) Increase your chances of an interview by reading the ... an application. Location: Scranton, Pennsylvania Job Category: LPN - Licensed Practical Nurse , Nursing and Nursing Support Schedule: Rotation Work Type: Full time… more
- Geisinger (Wilkes Barre, PA)
- Job Title: LPN- Experienced Inpatient Licensed Practical Nurse (Geisinger South Wilkes Barre, Wilkes Barre) The information below covers the role requirements, ... qualifications. Location: Wilkes-Barre, Pennsylvania Job Category: LPN - Licensed Practical Nurse , Nursing and Nursing Support Schedule: Rotation Work Type: Full… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …limited to experience, education, and other business and organizational considerations. Department: Utilization Management - UH FTE: 1.00 Full Time Shift: Days ... appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including census review,… more
- University Health (San Antonio, TX)
- …years recent, full time hospital experience preferred. Work experience in case management , utilization review, or hospital quality assurance experience is ... and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to… more
- University Health (San Antonio, TX)
- …Three years recent, full-time hospital experience preferred. Work experience in case management , utilization review or hospital quality assurance experience is ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice... is required. National certification in related field is preferred. Case Manager Certification (CCM or ANCC) is highly… more
- Sanford Health (Rapid City, SD)
- …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Huron Consulting Group (Chicago, IL)
- …Join our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, ... Review Plan and the overall operation of the Utilization Management Department in accordance with federal,...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Houston Methodist (Houston, TX)
- …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM ... to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of...types of case reviews for quality and appropriate medical management , cost containment, peer review and rehabilitation; + Implement… more
- Saint Francis Health System (OK)
- …their placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale Campus Location: Virtual Office, Oklahoma 73105… more
- Catholic Health (Kenmore, NY)
- …of experience working in an Acute Care Hospital Setting + Proficiency in utilization management and regulatory requirements preferred + Experience in working ... Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review, as an active...Manager (CCM) + Certification in a Nationally Recognized Utilization Review Criteria set is preferred + At least… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
- CenterWell (San Juan, PR)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...financial, and utilization goals through effective management , communication, and… 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 ... MO Compact within 60 days of hire + One of the following: American Case Management , Certified Case Manager required upon hire + Employees must obtain American… more
