- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On- Site Recruitment # 250715-5612FP-001 Location New Haven, CT Date Opened 7/22/2025 12:00:00 AM Salary $78,480 ... is seeking a highly motivated and compassionate U tilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) to join our team!… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral… more
- Beth Israel Lahey Health (Burlington, MA)
- …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Children's Hospital Boston (Boston, MA)
- …Title:Per Diem RN Case Manager, Utilization Management/ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard Hours per ... Posting Description:Department Summary: The UM Case Managers at Boston Children's review documentation within 1 business day of patient admission to assess… more
- Ochsner Health (Lafayette, LA)
- …or other related MCO departments/functions. **Certifications** Required - Current registered nurse (RN) license in state of practice. *MSW accepted in lieu ... of registered nurse (RN) licensure. Preferred - Certification in Case Management...Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains… more
- Corewell Health (Southfield, MI)
- Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates ... + Preferred Bachelor's Degree in nursing or related field. + Hospital utilization review / utilization management experience. Preferred + Clinical appeals… more
- Ascension Health (Baltimore, MD)
- …the internal Ascension Travel Program, please visit our site (https://about.ascension.org/our-work/associate-travel-program) . **Benefits** Paid time off (PTO) ... date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date required. Education: +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A....Medical Records as required for appeals , On / Off- site Insurance reviews + Implements first step of appeals… more
- Molina Healthcare (Idaho Falls, ID)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... appropriate and cost-effective based on the severity of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses services for members to ensure… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... or LPN License. + Minimum of one year of utilization review experience and discharge planning in...will take 2-4 weeks, involving shadowing a team member on- site on Tuesdays and remote shadowing via Teams. Pay… more
- Veterans Affairs, Veterans Health Administration (Charleston, SC)
- …documents, ensuring that the admission and continued stay process follows utilization review guidelines through application of established lnterQual criteria. ... Summary The Registered Nurse (RN) Inpatient Case Manager is responsible for...from admission to discharge. He/she is responsible for conducting utilization management activities reviews on observation, admission and continued… more
- Northwell Health (Riverhead, NY)
- …case management and clinical pathways, variance analysis and trending, quality management/ utilization review and home care/discharge planning, preferred. + Keeps ... another level of care according to regulatory standards. + * Performs concurrent utilization management + Conducts chart review for appropriateness of admission… more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Medical Center is recruiting for 1 Quality Management Registered Nurse for the Renal Transplant Program. At the full...program area activities for the Medical Center and all off- site locations. The QM RN collects data, monitors staff… more
- Mayo Clinic (Rochester, MN)
- …and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and continued stay ... to work well within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records, value based purchasing… more
- State of Colorado (Denver, CO)
- Assistant Nurse Manager - Nurse III -...Location: 3520 W Oxford Avenue, Denver, CO 80236 Full-Time, On- Site Monday - Friday 1400 - 2200 This position ... Fort Logan (S. Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5012615) Apply Assistant Nurse Manager - Nurse III - Colorado… more
- Ochsner Health (New Orleans, LA)
- …hospital-based experience in discharge planning, case management or utilization review . **Certifications** Required - Current registered nurse license in ... implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- State of Connecticut, Department of Administrative Services (Norwich, CT)
- Head Nurse (40 Hour) Office/On- Site Recruitment # 250715-4356FL-002 Location Norwich, CT Date Opened 7/22/2025 12:00:00 AM Salary $91,192 - $120,638/year ... experienced individual to join our team as a Head Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=4356FL&R1=&R3=) . POSITION HIGHLIGHTS: + SCHEDULE: Full -Time… more
- State of Connecticut, Department of Administrative Services (Bridgeport, CT)
- Nurse (Multiple Positions) Office/On- Site Recruitment # 250716-1969FL-001 Location Bridgeport, CT Date Opened 7/17/2025 12:00:00 AM Salary *Please see ... WISH TO APPLY FOR A CONNECTICUT LICENSE, PLEASE: + Review the eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Registered- Nurse /RN-Licensure-by-Endorsement)… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- …accepted on an ongoing basis and will remain on file through 9-30-2025. Initial review will be conducted approximately two weeks from the release date of this ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic… more
- Ventura County (Ventura, CA)
- …and patient care as indicated and required. + May participate in quality assurance/ utilization review or other non-direct patient care nursing assignments. + ... Registered Nurse II - ICU/DOU/Telemetry (Regular & Per Diem)...date. To apply on-line, please refer to our web site at www.ventura.org/jobs If you prefer to fill out… more