• CoxHealth (Branson, MO)
    …and utilization of Aseptic Technique. Licensure/Certification/Registration: ▪ Required:Missouri State Registered Nurse AND Certified as a Registered ... and utilization of Aseptic Technique. ◦ Licensure/Certification/Registration ▪ Required:Missouri State Registered Nurse AND Certified as a Registered more
    Talent (10/03/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    …eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) ... Utilization Review Nurse Coordinator... Utilization Review Nurse Coordinator (40 Hour) Office/On-site...(https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse ( RN ) interested in… more
    State of Connecticut, Department of Administrative Services (10/01/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
    The County of Los Angeles (09/27/25)
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  • Utilization Review Nurse (40…

    State of Connecticut, Department of Administrative Services (Hartford, CT)
    …eligibility and documentation requirements (https://portal.ct.gov/dph/practitioner-licensing--investigations/ registered - nurse / rn -licensure-by-endorsement) ... Utilization Review Nurse (40...(https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to… more
    State of Connecticut, Department of Administrative Services (10/03/25)
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  • Utilization Review Nurse

    Emory Healthcare/Emory University (Decatur, GA)
    …**Description** We're seeking a **Clinical Utilization Review Nurse Preceptor ( Registered Nurse / RN )** . This individual will be responsible for ... training, mentoring, and coaching for the Utilization Review Department and must be an...well as manage an active UR assignment/caseload. The UR RN Preceptor: + Will be regarded as a clinical… more
    Emory Healthcare/Emory University (10/02/25)
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  • Intensive Case Management - Medicare Advantage…

    UCLA Health (Los Angeles, CA)
    Description Under the direction of the Assistant Director, the ICM Medicare Advantage Utilization Review Nurse performs utilization review of medical ... enrolled under UCLA Medical Group. The ICM Medicare Advantage Utilization Review Nurse ensures that...Required: + BSN or MSN degree + Active CA RN License + Minimum of 2 years' experience in… more
    UCLA Health (10/02/25)
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  • Utilization Review Nurse

    Martin's Point Health Care (Portland, ME)
    …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...and offerings. Education/Experience: + Unrestricted state license as a Registered Nurse required; BSN preferred. + 3+… more
    Martin's Point Health Care (09/25/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
    Centene Corporation (10/03/25)
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  • Sr Utilization Review Specialist…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for promoting ... an expert level at all objectives delineated in the Utilization Review Nurse and ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (08/26/25)
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  • Inpatient Utilization Review

    Emory Healthcare/Emory University (Atlanta, GA)
    …and leadership programs + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting ... physician and/or physician advisor. This individual will: + Perform utilization review by completing a timely and...patient and hospital financial risk. + Initiate and facilitate RN to RN discussion and/or Physician to… more
    Emory Healthcare/Emory University (10/03/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (09/23/25)
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  • Utilization Review and Nurse

    Idaho Division of Human Resources (Nampa, ID)
    Utilization Review and Nurse Educator -...considered for this position. + Licensed as a Professional or Registered Nurse in Idaho as defined by Idaho ... Seniorto take on a critical role in our Utilization Review , Performance Improvement, Nursing Education programs....Code 54-1408 or state licensure as a Registered Nurse pursuant to the … more
    Idaho Division of Human Resources (09/23/25)
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  • Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
    Minnesota Visiting Nurse Agency (10/02/25)
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  • Behavioral Health Utilization Review

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments,...health. + Proficiency in clinical and utilization review processes. + Current unrestricted Florida RN more
    Actalent (10/04/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (10/02/25)
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  • Utilization Review Nurse

    Dayton Children's Hospital (Dayton, OH)
    …timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical record review for ... medical guidelines and communicates information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource to the… more
    Dayton Children's Hospital (10/04/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
    US Tech Solutions (07/18/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1...months of Prior Authorization. Education: . Active and unrestricted RN licensure in state of residence **About US Tech… more
    US Tech Solutions (07/18/25)
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  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …EXPERIENCE REQUIREMENT** + Five (5) years of health care experience as a Registered Nurse . **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a ... the unique communities we serve. **Summary:** This position facilitates utilization management processes to support the right care is...Registered Nurse in the state of North Carolina. **KNOWLEDGE, SKILLS… more
    UNC Health Care (09/04/25)
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