• Commonwealth Care Alliance (Boston, MA)
    …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is… more
    DirectEmployers Association (10/02/25)
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  • The George Washington University Hospital (Washington, DC)
    Responsibilities Job Title: Clinical Supervisor - Labor & Delivery Status: Full Time Schedule: 7pm-7am Night Shift The George Washington University Hospital is a ... shift oversight for clinical practice, staffing, patient flow, safety, service, and utilization of resources for daily operations. Maintains the environment of care.… more
    Appcast IO CPA (09/25/25)
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  • The George Washington University Hospital (Washington, DC)
    Responsibilities Job Title: Clinical Supervisor - Labor & Delivery Status: Full Time Schedule: Day *You will be considered for any openings for which you qualify. It ... shift oversight for clinical practice, staffing, patient flow, safety, service, and utilization of resources for daily operations. Maintains the environment of care.… more
    Appcast IO CPA (09/25/25)
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  • The George Washington University Hospital (Washington, DC)
    …shift oversight for clinical practice, staffing, patient flow, safety, service, and utilization of resources for daily operations. Maintains the environment of care. ... Qualifications Position Requirements: BSN required. 1 year resource relief nurse experience preferred Professional experience that demonstrates ability to understand… more
    Appcast IO CPA (09/22/25)
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  • ERP International (San Diego, CA)
    **Overview** ERP International is seeking a full-time **Registered Nurse (RN) Health Educator** supporting **Naval Medical Center San Diego, CA ... of other individuals performing similar services. ? Participate in peer review and performance improvement activities. ? Practice aseptic techniques as necessary.… more
    DirectEmployers Association (10/18/25)
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  • Commonwealth Care Alliance (Boston, MA)
    …require intensive care delivery.? Within the Care Delivery Program, the Supervisor , Care Delivery Patient Access is responsible for the successful administrative ... partnership with Care Delivery Business Ops and Clinical Management teams, the Supervisor partners in ensuring the delivery of primary care, complex care management… more
    DirectEmployers Association (09/30/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...implemented for compliance, as needed. + As a unit supervisor at the LA General Medical Center: + Has… more
    The County of Los Angeles (10/06/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (09/27/25)
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  • NCCPAC Revenue Utilization Review

    Veterans Affairs, Veterans Health Administration (Middleton, WI)
    Summary The Revenue Utilization Review (RUR) Assistant Nurse Manager (ANM) is a Registered Nurse (RN) who assists to control costs for VISN 10 and/or ... awareness of appropriate evidence-based practices for positive outcomes. Responsibilities The Revenue Utilization Review (RUR) Assistant Nurse Manager (ANM)… more
    Veterans Affairs, Veterans Health Administration (10/30/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    …the general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case management. + utilize ... Senior Registered Nurse - Hospital Management Utilization Print...Supervisor Pay - $4.00 per hour + Charge Nurse Premium Pay - $1.50 per hour + Float… more
    Ventura County (09/21/25)
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  • Supervisor , Utilization Management

    Centene Corporation (Sacramento, CA)
    …perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review ... team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
    Centene Corporation (10/15/25)
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  • Supervisor , Behavioral Health…

    Centene Corporation (Phoenix, AZ)
    …and be licensed in Arizona **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and ... of BH utilization management team. + Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines +… more
    Centene Corporation (10/23/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials....Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (10/10/25)
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  • Registered Nurse (Nursing Education Program…

    Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
    …as well as customer service programs. Program Manager (PM) Registered Nurse (RN) Supervisor executes position responsibilities that demonstrates leadership, ... and creative approaches to the management of program aspects. The PM Supervisor demonstrates performance and leadership that is broad enough to impact the… more
    Veterans Affairs, Veterans Health Administration (10/30/25)
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  • Registered Nurse Supervisor A

    Louisiana Department of State Civil Service (Jackson, LA)
    REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/5124511) Apply  REGISTERED NURSE SUPERVISOR A Salary ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding patient… more
    Louisiana Department of State Civil Service (10/29/25)
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  • House Supervisor Admin Registered…

    HCA Healthcare (Richmond, VA)
    …you, we encourage you to apply for our House Supervisor Admin Registered Nurse RN opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as a(an) House Supervisor Admin Registered Nurse RN and access...will demonstrate fiscal responsibility by assuring appropriate departmental staffing utilization + You will assure that all staff demonstrate… more
    HCA Healthcare (10/24/25)
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  • Supervisor Care Management Registered…

    AdventHealth (Winter Park, FL)
    …Avenue Winter Park Florida 32792 **The role you'll contribute:** The Care Management Supervisor is under the general leadership of the Care Management Manager or ... supervision of team members in the Care Management department. The Care Management Supervisor is responsible for the daily front line operations as assigned by the… more
    AdventHealth (10/22/25)
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  • Insurance Specialist-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
    Mount Sinai Health System (10/22/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Washington, DC)
    …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... ON BONUS** **Role Overview:** Under the direction of a supervisor , the Clinical Care Reviewer - Utilization ...cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health… more
    AmeriHealth Caritas (09/01/25)
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  • Utilization Management Coordinator

    Saint Francis Health System (Tulsa, OK)
    …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... administrative and clinical support to the hospital and treatment team throughout the review of patients, their placement in various levels of care and their receipt… more
    Saint Francis Health System (10/08/25)
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