• Clinical Nurse Manager, Home Health

    Baystate Health (Springfield, MA)
    …subordinates as necessary. Resolving routine personnel problems. Authorize and review utilization of home health nursing, social work, occupational, ... looking for a** **Clinical Nurse Manager** **to join our** ** Home Health ** **team!** **Why choose Baystate Homecare?**...speech therapy for medical necessity and appropriateness of care. Review plans of care to ensure functional outcomes and… more
    Baystate Health (06/05/25)
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  • Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Orlando, FL)
    …Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding_ **As an ... considered, there is no flexibility around this requirement.** BAYADA Home Health Care is hiring a full... Review Manager provides support to all BAYADA Home Health Care Medicare service offices by… more
    BAYADA Home Health Care (05/17/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Orlando, FL)
    …leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, Coder, Medicare **As ... considered, there is no flexibility around this requirement.** BAYADA Home Health Care has an immediate opening...immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work… more
    BAYADA Home Health Care (05/17/25)
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  • Managed Long Term Services and Supports Nurse…

    LA Care Health Plan (Los Angeles, CA)
    …and/or disabilities in a UM/CM environment. Preferred: Experience in utilization review , skilled nursing, home health , discharge planning, behavioral ... care, palliative care, hospice care OR experience in Utilization Review or Care Management will be...health , community resources, and/or other home and community-based agencies. Skills Required: Excellent verbal and… more
    LA Care Health Plan (06/17/25)
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  • Acute Care Case Manager , Registered Nurse…

    ChenMed (North Miami Beach, FL)
    …work experience required. + A minimum of 1 year of utilization review and/or case management, home health , hospital discharge planning experience ... other case managers and nurses, acute and post-acute facilities, home health care companies, and health...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
    ChenMed (05/28/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …Description:** The Inpatient Registered Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning ... in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital...review medical necessity and discharge planning) **As a health care organization, we have a responsibility to do… more
    Beth Israel Lahey Health (04/16/25)
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  • Acute Nurse Case Manager (RN)

    ChenMed (St. Louis, MO)
    …clinical work experience required + A minimum of 1 year of utilization review and/or case management, home health , discharge planning experience required ... other case managers and nurses, acute and post-acute facilities, home health companies, and health ...discharge planning. **KNOWLEDGE, SKILLS AND ABILITIES:** + Knowledge of Utilization Review (UR) and discharge planning +… more
    ChenMed (03/25/25)
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  • Behavioral Health Utilization

    Actalent (Sunrise, FL)
    …+ Prepare and present reports on department activities as assigned. Essential Skills + Clinical review + Utilization review + Utilization management + ... of resources such as durable medical equipment, hospitalizations, and home healthcare. + Provide current and timely documentation reflecting...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
    Actalent (06/20/25)
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  • Utilization Review Medical Director

    Intermountain Health (Las Vegas, NV)
    …1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review , quality ... + Five years in a professional setting such as hospital, clinic, or home health environment. + Strong analytical and problem-solving skills. + Experienced… more
    Intermountain Health (06/03/25)
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  • Utilization Review Care Management…

    Intermountain Health (Las Vegas, NV)
    **Job Description:** The Utilization Review Care Management Director is responsible for providing leadership and administrative direction for Utilization ... metrics. Leads the system-wide development of partnerships with payors to support Utilization Management. Collaborates with Castell, Home Care, Clinic Management… more
    Intermountain Health (06/11/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Omaha, NE)
    **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize ... position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is...by faith. Driven by innovation. Powered by humankindness. CHI Health , now part of CommonSpirit Health , is… more
    Catholic Health Initiatives (04/23/25)
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  • Physician Advisor, Utilization

    Sutter Health (Sacramento, CA)
    …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... organization's goals and objectives for ensuring the effective, efficient utilization of health care services. The PA...(CMS) preferred. + Post-acute levels of care such as Home Health , Hospice, Advance Illness Management (AIM),… more
    Sutter Health (06/12/25)
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  • Utilization Review Clinician…

    Centene Corporation (Austin, TX)
    …related to mental health and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience ... role have the flexibility to work remotely from their home anywhere in the Eastern or Central time zone,...or have a compact RN license with previous behavioral health experience. **Position Purpose:** Performs a clinical review more
    Centene Corporation (06/04/25)
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  • RN Registered Nurse - Utilization

    Ascension Health (Wichita, KS)
    **Details** + **Department:** Utilization Review + **Schedule:** Full time, 36 hrs, Day shift, 7:30 AM- 4:00 PM, Monday-Friday, rotating weekends possible + ... care services regarding admissions, case management, discharge planning and utilization review . + Review admissions...across a number of hospitals, clinics, therapy centers and home health services. Ascension is a leading… more
    Ascension Health (06/18/25)
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  • Utilization Review Specialist, DH

    Nuvance Health (Danbury, CT)
    …duties as required. Education: ASSOCIATE'S LVL DGRE Preferred : Two Years of Utilization Review experience Required : CT Registered Nurse License Working ... *Description* Nuvance Health has a network of convenient hospital and...Non-acute care is offered through various affiliates and the Home Care organizations. Work Type : Part Time Hours… more
    Nuvance Health (06/07/25)
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  • RN Utilization Review Registered…

    Ascension Health (Jacksonville, FL)
    health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests within ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (06/18/25)
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  • Utilization Review Services RN

    HCA Healthcare (Nashville, TN)
    **Description** **Introduction** Do you have the career opportunities as a(an) Utilization Review Services RN you want with your current employer? We have an ... Other, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...of colleagues. Do you want to work as a(an) Utilization Review Services RN where your passion… more
    HCA Healthcare (06/17/25)
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  • Utilization Review RN

    Dignity Health (Glendale, CA)
    …the individual to competently perform the job. + Five (5) years experience in utilization review and discharge planning, case management and managed care. Other ... centers, including hospitals, urgent and occupational care, imaging and surgery centers, home health , and primary care clinics. Headquartered in San Francisco,… more
    Dignity Health (06/01/25)
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  • Utilization Review Services…

    HCA Healthcare (Nashville, TN)
    …Do you want to join an organization that invests in you as a Utilization Review Services Coordinator? At Parallonr, you come first. HCA Healthcare has ... Parallon, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...make a difference. We are looking for a dedicated Utilization Review Services Coordinator like you to… more
    HCA Healthcare (06/17/25)
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  • Utilization Review Medical Director

    Integra Partners (Troy, MI)
    Position Summary + Integra Partners is seeking a full-time Utilization Review Medical Director to support our Utilization Management team. This is a ... health plan criteria. + Function within a daily review queue, processing cases throughout the day as part...the local delivery system rendering the criteria inappropriate, the Utilization Management Nurse will route the case to the… more
    Integra Partners (06/07/25)
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