- 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
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...to make an impact** **Required Qualifications** + Active enhanced Registered Nurse , (eNLC) license (RN) with no… 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
- 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
- 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
- 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
- CVS Health (St. Paul, MN)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- HCA Healthcare (Nashville, TN)
- …4 years of relevant case management / utilization review experience preferred + Registered Nurse - Currently licensed as a registered professional ... an organization that invests in you as a NICU Utilization Review Services RN? At Parallon, you come first....a difference. We are looking for a dedicated NICU Utilization Review Services RN like you to be a… more
- Centene Corporation (Jefferson City, MO)
- …degree and 4+ years of related experience. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse ... to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- Ochsner Health (New Orleans, LA)
- …develop and implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson Highway PRN ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… 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
- Veterans Affairs, Veterans Health Administration (Cheyenne, WY)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, consult ... level degree in Nursing may have opportunity to become registered as a nurse with a state...responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice… 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
- Ochsner Health (New Orleans, LA)
- …a difference at Ochsner Health and discover your future today!** This job is a registered Nurse with a diverse medical background, who is able to determine the ... Contents are subject to change at Ochsner's discretion. **Education** Required - Registered Nurse Diploma or equivalent **Work Experience** Required - 1… 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 &...TH Comments **Similar Jobs** ICU RN - Intensive Care Registered Nurse MercyOne Registered Nurse ... 1 Positions ID: 4627707008 Posted On 07/01/2025 **Job Overview** ** Utilization Management Nurse ** **Location** :... (RN) Senior Care MercyOne RN - Float Pool Registered Nurse MercyOne RN - Onsite Virtual… more
- Houston Methodist (The Woodlands, TX)
- …the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --...state, local, and federal programs + Progressive knowledge of utilization management , case management , performance… more