- Medical Solutions (Omaha, NE)
- …CA is seeking its next amazing RN ( Registered Nurse) to work in Case Management ( Utilization Review ). Read on if this sounds like your perfect fit! ... Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel healthcare helps you hone… more
- Geisinger (Wilkes Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Location: Wilkes-Barre, Pennsylvania Job Category: Inpatient RN - Registered ... and Nursing Support Schedule: Rotation Work Type: Full time Department: Talent Management Nursing & Nursing Support Team Date Posted: 04/29/2025 Job ID: R-77849… more
- AmeriHealth Caritas Health Plan (Philadelphia, PA)
- …services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape ... judgment, and meaningful collaboration. Lead with Clinical Insight. Whether you're an experienced utilization review nurse, a sharp case manager, or a behavioral… more
- Geisinger (Scranton, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton) Location: Scranton, Pennsylvania Job Category: Inpatient RN - Registered ... and Nursing Support Schedule: Rotation Work Type: Full time Department: Talent Management Nursing & Nursing Support Team Date Posted: 04/29/2025 Job ID: R-77850… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …department budget, staffing, and training needs. Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse (RN) with a ... (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review , case management . Strong working knowledge of hospital billing,… more
- Boston Childrens Hospital (Boston, MA)
- …preferred. Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: Current Massachusetts license as ... Job Posting Description Department Summary: The UM Case Managers at Boston Children's review documentation within 1 business day of patient admission to assess for… more
- Valley Health System (Paramus, NJ)
- …5 years'" cents experience in clinical nursing, minimum of 3 years in case management / utilization . SPECIAL SKILLS: Registered Nurse, Licensed in State of ... POSITION SUMMARY: Performs concurrent utilization review activities on all patients...Commercial payors guidelines. Monitors and intervenes on LOS, resource utilization and denial management / prevention within the… more
- Surgery Partners (Bryan, TX)
- …Current Registered Nurse (RN) license in the state of practice Experience in utilization review , acute hospital case management , or quality assurance is ... Job Summary: We are seeking a Part-Time Utilization Review Nurse to join our...resources in advocating for patient needs with judicious resource management Assures the patient is in the appropriate status… more
- Kaiser Permanente (Los Angeles, CA)
- …utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review / management , discharge planning or case ... the interdisciplinary approach to providing continuity of care, including Utilization management , Transfer coordination, Discharge planning, and obtaining… more
- Software Placement Group (White Plains, NY)
- …health team members. Document activities as per department requirements and perform utilization review activities per department policy. Contribute to department ... Registered Nurse Care Manager The role of the...multitasking and retaining composure under stress. Preferred Qualifications: Care Management Certification (eg, CMC, CCM). 3+ years of clinical… more
- Kaiser Permanente (Sacramento, CA)
- …assigned areas. Essential Responsibilities: Assists in the coordination of the quality management / utilization management department activities. Acts as a ... consultant for appropriate departments on quality management , utilization management ...(3) years of home care nursing experience or quality utilization review experience. Education Bachelors degree in… more
- AdventHealth (Altamonte Springs, FL)
- …documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...in Nursing Health-related master's degree or MSN Prior Care Management / Utilization Management experience Professional… more
- NavitsPartners (Boston, MA)
- …or case management role Demonstrated experience in discharge planning and utilization review within the past 4 years Working knowledge of InterQual(R) ... Job Title: Travel - Registered Nurse (RN) - Case Management Location:...or equivalent clinical review system Case Management certification (CCM, CPUM, or… more
- Day Kimball Healthcare (Putnam, CT)
- …the Case Management Department functions and activities to include Utilization Review /Case Management /Clinical Documentation/RAC. Carries out the duties ... Day Kimball Health is hiring for a Registered Nurse, Case Manager for Case Management...preferred. Knowledge of regulatory issues that direct healthcare, compliant utilization management , compliant care management … more
- Northwestern Memorial Healthcare (Lake Forest, IL)
- …of our employees. Ready to join our quest for better? Job Description The Registered Nurse BSN embodies the attributes of the Relationship Based Care model and ... on a regular basis, and through participation in clinical case peer review . Works collaboratively with all hospital services to responsibly accomplish daily work… more
- Northwell Health (Riverhead, NY)
- …to another level of care according to regulatory standards. * Performs concurrent utilization management Conducts chart review for appropriateness of ... management and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge planning, preferred.… more
- LHC Group, Inc. (Trumbull, CT)
- …demands of our patients. Adheres to and participates in the agency's utilization management model. Qualifications License Requirements Current RN licensure in ... Job Description The Registered Nurse in Home Health provides and directs...offer benefits that support your physical and emotional wellbeing. Review LHC Group's comprehensive benefits and perks: https://bit.ly/LHCGBenefits Patient… more
- Valley Presbyterian (Los Angeles, CA)
- …level of customer satisfaction in the most cost-effective manner. Responsible for Utilization Management , Case Management , and Discharge planning activities ... Job Summary: As a Registered Nurse/Case Manager, Case Management Unit,...with Critical Care experience desirable. Previous experience in Case Management , Utilization Management , or Discharge… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing program. Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. ... Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of First Refusal (ROFR) requests, review of Specialty… more
- Lorenz Clinic (Wayzata, MN)
- Job Type Part-time Description Position Overview The Registered Nurse plays an integral role within the overall clinic. They serve as a point person for the ... in teaching/educating patients and coordinating/providing patient care around medication management in an outpatient behavioral health clinic for patients with… more
