- Veterans Affairs, Veterans Health Administration (Little Rock, AR)
- Summary Under the supervision of the Nurse Manager, the Utilization Management Nurse will ensure that patients meet appropriate admission and continued ... the supervision of the Nurse Manager, the Utilization Management Nurse will ensure...licensure/certification. Preferred Experience: 4 Years of nursing experience with 2 years of Utilization Management … more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN...clinical experience in an acute hospital setting. At least 2 years of Utilization Management /Case ... nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN… more
- CVS Health (Columbus, OH)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area + Managed Care experience preferred, especially Utilization Management + Preference for those residing in EST zones **Education**… more
- Adecco US, Inc. (Houston, TX)
- Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Management Nurse in Houston, TX! This role is hybrid with a mix of work from home ... 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Management Nurse :** . Responsible...nursing * Current, unrestricted RN License in Texas . 2 to 5 years of experience in a managed… more
- Adecco US, Inc. (Houston, TX)
- …* Current, unrestricted RN License in Texas . 2 to 3 years of clinical nurse /case management experience . 2 to 3 years of coding experience . Strong ... Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This role is in person / on site. Please read below and… more
- Katmai (Fort Carson, CO)
- …is required. + Minimum of two ( 2 ) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... licensed in Colorado, be able to practice using a nurse compact state license or have a license from...checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- Elevance Health (Woodbridge, VA)
- … management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination ... is located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of...the District of Columbia is required. **Preferred Qualifications:** + Utilization Management /Review in managed care strongly preferred.… more
- CDPHP (Albany, NY)
- …care experience is required as a Registered Nurse . + Minimum of two ( 2 ) years Utilization Management experience is preferred. + Knowledge of ... you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for...transportation, DME requests and inpatient readmissions. In collaboration with management , the UR nurse identifies potentially high-cost… more
- Catholic Health (Buffalo, NY)
- …with Weekend and Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager- Utilization Review, as an active member of the Care ... Management and interdisciplinary care team, provides comprehensive ...obtained within 6 months + National Certification in Case Management preferred EXPERIENCE + Two ( 2 ) years… more
- UPMC (Hanover, PA)
- …(CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and ... hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part...required with 4-6 weeks of hire. UPMC approved Care Management certification preferred. + Registered Nurse (RN)… more
- Dignity Health (Gilbert, AZ)
- …**Responsibilities** Under the general direction of the Director of Care Management , performs criteria-based concurrent and retrospective utilization review to ... use of resources; promote quality patient care; assist with patient care management ; comply with applicable standards and regulations and provide information and… more
- Emory Healthcare/Emory University (Decatur, GA)
- …more! **Description** **8a-5:30p / Full Time / 36 hours** The **(RUN) Resource Utilization Nurse , LTAC** is primarily responsible for supporting the critical ... direct patient care assignment as needed while the primary nurse is off unit with another patient, and assisting...indvidual: + May assist the emergency department in the management of critical care patients awaiting inpatient bed admission… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/176615/ utilization -review- nurse -lvn/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... 360 outpatient locations in 14 states providing more than 2 .5 million patient visits annually. It is one of...Minimum two years of experience in acute hospital case management or equivalent. + Utilization Management… more
- Truman Medical Centers (Kansas City, MO)
- …time **Work Schedule** 7:00AM - 3:30PM **Hours Per Week** 4 **Job Description** ** Utilization Management Nurse (UM RN)** _Optimize Care. Improve Outcomes. ... log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Management RN Hourly (PRN) - Care Continuity -… more
- AdventHealth (Altamonte Springs, FL)
- …avoidance strategies including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a designated ... **The role you will contribute:** The role of the Utilization Management (UM) Registered Nurse ...plan, and/or best practice guidelines, on a continuing basis. 2 ) Performs pre-admission status recommendation in Emergency Department or… more
- Humana (Frankfort, KY)
- …role overseeing staff + 2 + years of experience working in Utilization Management processing clinical authorizations + Licensed Registered Nurse (RN) ... community and help us put health first** The Manager, Behavioral Health Utilization Management uses clinical knowledge, communication skills, and independent… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + ... + Req #:41909-31047 + FTE:1 + Posted:April 28, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
- LA Care Health Plan (Los Angeles, CA)
- …of acute/clinical care experience. Minimum of 2 years of experience in Case/Care/ Utilization Management in an acute care or health plan setting. Minimum of ... Supervisor, Utilization Management RN Job Category: Clinical...nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get… more
- Ascension Health (Nashville, TN)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours a week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...experience required. + 10 years of experience preferred. + 2 years of leadership or management experience… more
- Beth Israel Lahey Health (Burlington, MA)
- …of three years of medical/surgical nursing care experience. -Two years of Case Management or Utilization Management experience desirable. - Demonstrated ... in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital...to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and… more