- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case Manager @ Providence Little Company of Mary Medical ... 09/08/2025 End Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management Duration:… more
- ERP International (Tinker AFB, OK)
- **Overview** ERP International, LLC is seeking a ** Registered Nurse - Case Manager ** for a full-time position supporting **SHG Clinic** in support of ... **Be the Best!** Join our team of exceptional health care professionals across the nation. Come discover the immense...or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. Security**… more
- HealthCare Support (Houston, TX)
- Utilization Review RN HealthCare Support is actively seeking a Utilization Review RN to fill an opening with a Prestigious HealthCare Company in Remote ... Houston TX . Daily Responsibilities for Utilization Review RN : WIll need to use...clinical information to authorize medically necessary inpatient and outpatient care , utilizing nationally recognized evidenced based clinical criteria or… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible ... facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance… more
- StaffDNA / Santa Fe Service Unit (PHS Indian Hospital) (Santa Fe, NM)
- …) Job Summary : A Case Manager Registered Nurse ( RN ) coordinates and manages the care of patients, ensuring they receive appropriate, cost-effective, ... Duration 32 Week(s) Job Description Job Title : Case Manager Registered Nurse ( RN...care across multiple healthcare settings, ensuring continuity of care , appropriate utilization of resources, and adherence… more
- Boost Home Health (Southfield, MI)
- …the healthiest and happiest state of being possible. The Clinical Manager is a Registered Nurse ( RN ) who has graduated from an accredited school of ... of professional nursing who is currently licensed as a registered nurse in the state of Michigan....nurse in the state of Michigan. Current unrestricted RN license in the state of Michigan Two (2)… more
- Alameda Health System (San Leandro, CA)
- SLH Case Manager RN + San Leandro, CA + San Leandro Hospital + SLH Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req ... + FTE:0.7 + Posted:October 28, 2025 **Summary** **JOB SUMMARY** The SLH Case Manager RN is responsible for providing comprehensive case management services to… more
- Providence Little Company of Mary Medical Center San Pedro-… (San Pedro, CA)
- …Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services ... of Mary Medical Center San Pedro- Case Management Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 33531148 Job Title RN -… more
- Stony Brook University (Stony Brook, NY)
- …communication skills while adhering to our high standard of excellence. **Duties of a RN Case Manager in the Care Management Department may include ... RN Case Manager **Position Summary** At...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN… more
- Stanford Health Care (Palo Alto, CA)
- …the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact State ... Manager differs from other roles in professional nursing/health care practice in that it is not intended to...collaboration with other interdisciplinary team members; arranges follow up care as appropriate. + Utilization Review --… more
- Somatus (Utica, NY)
- …appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site or telephonically as the need arises. **This is ... Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the...departmental policies and procedures. Qualifications Required Qualifications: - Active RN license in NY with the ability to qualify… more
- Commonwealth Care Alliance (Springfield, MA)
- …- As a member of the management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide input on ... them at home, by providing best-in-class disability competent primary care . Within Care Delivery, the Manager...clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment… more
- Commonwealth Care Alliance (Boston, MA)
- …- As a member of the management team, shared accountability for reductions in acute care utilization - Attend team meetings and huddles to provide input on ... member of Care Delivery Leadership, the Primary Care Nursing Manager is the nursing leader...clinical experience including: - 3+ years' experience as a Registered Nurse in a high-touch clinical environment… more
- BlueCross BlueShield of Tennessee (Memphis, TN)
- …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... they need to meet their complex needs\. As a Care Transition Case Manager , you will play...have you on our team\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases… more
- Rady Children's Hospital San Diego (San Diego, CA)
- **Please note this is not a remote position. JOB SUMMARY: The Triage Resource RN functions at the Standard Level of nursing practice and is responsible for the ... independent application of the nursing process while providing patient care . This includes, but is not limited to patient and family education, using department… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …always rewarding. **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Nurse Care Manager performs complex discharge planning ... degree in Nursing, Health Care Administration, or related field preferred. Current Registered Nurse licensure in the State of California and AHA CPR/BLS… more
- Daiichi Sankyo, Inc. (Chesapeake, VA)
- …driver's license with a driving record that meets company requirements Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact ... customer needs.Monitor, collect, and communicate to the Director, Clinical Nurse Manager on customer insights regarding their...State Licensure The ideal candidate will be a Registered Nurse with previous relevant clinical as… more
- Commonwealth Care Alliance (Boston, MA)
- …Long-Term Services Coordinators (LTSC) agencies, ensuring alignment with CCA's model of care and strategic objectives. The Manager fosters effective clinical and ... are met in a manner that supports quality, independence, and cost-effective community-based care . The Manager also ensures providers are educated on CCA… more
- Commonwealth Care Alliance (Boston, MA)
- …supporting high-quality, coordinated care for members. In this role, the Program Manager acts as an account manager , relationship manager , and ... teams to ensure a seamless provider experience and consistent delivery of quality care . The BH Provider Engagement Program Manager reports to the Director… more
Related Job Searches:
Care,
Care Manager,
Care Manager RN,
Manager,
RN,
RN Utilization,
Utilization,
Utilization Manager,
Utilization Manager RN