• Registered Nurse

    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
    ERP International (06/18/25)
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  • Utilization Management

    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
    Humana (07/09/25)
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  • Utilization Management

    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
    McLaren Health Care (06/07/25)
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  • Utilization Management RN

    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
    Ellis Medicine (07/02/25)
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  • Utilization Review Intake RN Behavioral…

    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
    AdventHealth (06/13/25)
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  • Health Plan Nurse Coordinator

    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
    Actalent (07/10/25)
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  • Utilization Management Nurse

    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
    CVS Health (07/09/25)
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  • NICU Utilization Review Services RN

    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
    HCA Healthcare (07/10/25)
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  • Supervisor, Utilization Management

    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
    Centene Corporation (06/25/25)
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  • Registered Nurse (RN) Case Manager…

    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
    Ochsner Health (04/30/25)
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  • NCCPAC Revenue Utilization Review (RUR)…

    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 (07/03/25)
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  • Registered Nurse (Community Care…

    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
    Veterans Affairs, Veterans Health Administration (07/10/25)
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  • Registered Nurse Utilization

    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
    LifePoint Health (05/15/25)
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  • Utilization Review Registered

    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
    Emory Healthcare/Emory University (07/02/25)
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  • Registered Nurse

    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
    Ascension Health (06/27/25)
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  • Registered Nurse (RN)…

    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
    Ochsner Health (07/11/25)
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  • Utilization Review Nurse Supervisor…

    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
    The County of Los Angeles (05/22/25)
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  • Registered Nurse

    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
    Beth Israel Lahey Health (05/17/25)
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  • Utilization Management Nurse

    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
    Access Dubuque (07/03/25)
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  • Utilization Review Nurse - Case…

    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
    Houston Methodist (07/12/25)
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