• Heywood Hospital (Gardner, MA)
    …and/or Insurance Industry preferred Minimum License and Certifications Current Massachusetts Registered Nurse License Required Skills Interqual experience or ... Utilization Management- Utilization Review and Care Transitions & Coordination Providing clinical information to payers, monitoring length of stay, seeking necessary… more
    Upward (07/23/25)
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  • ATC White Plains (White Plains, NY)
    …and federal programs strongly preferred Experience in use of Milliman/InterQual criteria Registered Nurse ( RN ) NYS license required PRI/Screen certification ... The RN Care Manager performs the initial comprehensive assessment...ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy. Essential Functions and Responsibilities… more
    Upward (07/11/25)
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  • Temple University (Philadelphia, PA)
    …InterQual criteria (Preferred) License/Certifications RN -LIC - PA Registered Nurse License (Required) CCM - Certified Case Manager (Preferred) Your ... collaboration with the patient/family, physicians, and the interdisciplinary team, the Case Manager facilitates the patient's progress through the acute episode of… more
    Upward (07/06/25)
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  • Renown Health (Reno, NV)
    …Ability to obtain and maintain a State of Nevada Registered Nurse license Certification(s): National Certification (ie Case Management (CCM), Professional ... Appropriate education to obtain and maintain State of Nevada Registered Nurse licensure. Bachelor of Science in...One year experience preferred as an RN . Case Management, Post-Acute experience and/or UR /QA experience… more
    Upward (07/11/25)
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  • Monadnock Community Hospital (Peterborough, NH)
    …error, falls, etc.) as determined by the interdisciplinary care team and in collaboration with the RN UR / Case Manager and other members of the care team, ... your passion for patient care and teamwork. The SW Case Manager is responsible for working with patients, families...families of patients, the public and co-workers. Good overall clinical skills required. Demonstrated ability to function well as… more
    Upward (07/18/25)
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  • Baptist Health (Little Rock, AR)
    …care/ procedures communicates with Chief of Clinical Affairs as needed for case review. The Access Nurse obtains Physician admit status order from the ... position responsible for the collection, aggregation, analysis, and reporting of complex clinical data. The Access Nurse assists with screening for… more
    Upward (07/19/25)
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  • Registered Nurse ( RN

    LifePoint Health (Hickory, NC)
    * Registered Nurse ( RN ), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound ... CMS, HCFA, AHCA). * Mentors staff on Utilization Review ( UR ) standards and Length of Stay (LOS) topics. *4....employment." **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN ), Clinical Case more
    LifePoint Health (07/16/25)
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  • Utilization Review Registered Nurse

    Emory Healthcare/Emory University (Atlanta, GA)
    …and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor ( UR RN Preceptor) will be responsible for training, ... UR assignment/caseload. + The UR RN Preceptor will be regarded as a clinical...standards, and case management systems. + The UR RN Preceptor understands the key performance… more
    Emory Healthcare/Emory University (07/19/25)
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  • UR Clinical Specialist

    Community Health Systems (Franklin, TN)
    …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... requirements. + Documents all utilization review activities in the hospital's case management software, including clinical reviews, escalations, avoidable days,… more
    Community Health Systems (07/09/25)
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  • Manager, Case Management and UR

    Seattle Children's (Seattle, WA)
    …employees in a clinical setting **Required Credentials** Current Washington State RN license. National certification in case management must be obtained ... provides leadership, supervision, and oversight of day-to-day operations of the Case Management department. Serves as the central resource to the director… more
    Seattle Children's (06/17/25)
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  • Case Mgmt/ UR Specialist-PBH

    Parkview Health (Fort Wayne, IN)
    …(ASN); Bachelor of Science in Nursing (BSN) preferred. Licensure/Certification Current Indiana RN license. CPI required upon hire or within 3 months of employment. ... 3 months of employment. Experience Two years of psychiatric nursing. Case management, quality assurance experience preferred. Other Qualifications Application of and… more
    Parkview Health (06/20/25)
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  • Registered Nurse (Utilization…

    Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
    …of the interdisciplinary team. Responsibilities Duties include but not limited to: Utilization Review ( UR ) Registered Nurse ( RN ) is responsible for ... and discharge/disposition planning for inpatient and outpatient settings. The UR RN assists Veterans, family members, and...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (07/24/25)
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  • Workers Compensation Support Registered

    AdventHealth (Altamonte Springs, FL)
    …Remote **The role youll contribute:** A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management for Workers ... nursing (BSN) preferred. + Minimum of 2 years of clinical nursing experience, preferably in occupational health, case...is essential **LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:** + Active Registered Nurse ( RN ) license in… more
    AdventHealth (07/22/25)
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  • Utilization Review Registered Nurse

    BJC HealthCare (St. Louis, MO)
    **City/State:** Saint Louis, Missouri **Categories:** Case Coordination **Job Status:** PRN **Req ID** : 86873 **Pay Range:** $32.80 - $50.39 / hour (Salary or ... (commercial, behavioral health, inpatient, ect) **Requirements:** + 2 years of staff nurse experience performing care for hospitalized patients. + 2 years of… more
    BJC HealthCare (07/12/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Sayre, PA)
    …BSN within two (2) years of hire. Individual consideration may be given to a registered nurse , with significant clinical experience, who holds a bachelor's ... based on assessed needs and available resources. The Acute Case Manager monitors clinical approaches and make...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
    Guthrie (07/17/25)
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  • San Leandro Hospital Case Manager RN

    Alameda Health System (San Leandro, CA)
    …AHA-American Heart Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. PAY RANGE: $78.33 ... San Leandro Hospital Case Manager RN , Per Diem, Days,...Association. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
    Alameda Health System (05/22/25)
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  • Director of Case Management ( RN

    Select Medical (Madison, WI)
    …Illness Recovery Hospital** **Director of Case Management** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... high-quality care and doing well by doing what is right. As the Director of Case Management **,** you will use your clinical knowledge and contribute to the… more
    Select Medical (07/23/25)
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  • Director of Case Management ( RN

    Select Medical (Newport News, VA)
    …Illness Recovery Hospital** **Director of Case Management** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... high-quality care and doing well by doing what is right. As the Director of Case Management **,** you will use your clinical knowledge and contribute to the… more
    Select Medical (07/08/25)
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  • Acute Nurse Case Manager ( RN

    ChenMed (St. Louis, MO)
    … with Bachelor Degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + A minimum ... expanding and we need great people to join our team. The Acute Care Nurse (ACN) is responsible for achieving positive patient outcomes. The incumbent in this role… more
    ChenMed (06/23/25)
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  • RN / Case Manager-MSH- Case

    Mount Sinai Health System (New York, NY)
    …for assessment, communication and monitoring of discharge planning process (The clinical nurse initiates the discharge planning process on admission). ... **Job Description** ** RN / Case Manager MSH Case ...expedite diagnostic testing, treatment and consultations. d. Documents all clinical reviews in Case Management Documentation system.… more
    Mount Sinai Health System (07/15/25)
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