• HCA HealthONE Rose (Denver, CO)
    …absence) Employee Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more about Employee ... on unit and staff performance issues needing attention. Maintains effective utilization and maintenance of manpower, equipment, and supplies. Other duties as… more
    JobLookup XML (01/10/26)
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  • NHS Management (Huntsville, AL)
    …facility policies and procedures Support quality assurance, infection control, and utilization review activities during night operations Receive, communicate, ... JOB DETAILS The full job description covers all associated skills, previous...and implement physician orders as needed Oversee delegation of nursing and… more
    JobLookup XML (01/08/26)
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  • NHS Management (Madison, AL)
    …in maintaining resident care standards related to quality assurance, infection control, and utilization review Receive and communicate physician orders and ... Not sure what skills you will need for this opportunity Simply read the full description below to get a complete picture of candidate requirements. The Good Stuff… more
    JobLookup XML (01/08/26)
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  • NHS Management (Athens, AL)
    …through oversight of quality assurance, infection control, and utilization review activities Receive and communicate physician instructions related to ... Stuff - At a Glance LPN Weekend Supervisor $10,000 Sign-On Bonus ( Full -Time Only) Leadership Role in Long-Term Care & Rehab Home-Like, Resident-Focused Environment… more
    JobLookup XML (01/08/26)
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  • Utilization Review Physician

    Hackensack Meridian Health (Hackensack, NJ)
    The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case...Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The… more
    Hackensack Meridian Health (12/30/25)
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  • Physician Utilization Review

    Hackensack Meridian Health (Hackensack, NJ)
    **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case...Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The… more
    Hackensack Meridian Health (11/12/25)
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  • Nurse Practitioner / Physician Assistant…

    Hackensack Meridian Health (Hackensack, NJ)
    …(APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating competencies in ... and Abilities Required: 1. Successful completion of an approved physician 's assistant program, accredited by the AMA Council on...Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The… more
    Hackensack Meridian Health (11/29/25)
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  • Utilization Review Nurse Supervisor…

    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 NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (12/25/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...$177,314.88 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening… more
    The County of Los Angeles (12/27/25)
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  • Manager - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full -time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
    Minnesota Visiting Nurse Agency (12/06/25)
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  • Senior Utilization Review Medical…

    Integra Partners (Troy, MI)
    …operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director(s), ensures consistent application of criteria, ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director's responsibilities include but are not… more
    Integra Partners (12/03/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
    University of Utah Health (01/06/26)
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  • Utilization Review Case Mgr - CMC…

    UTMB Health (Webster, TX)
    Utilization Review Case Mgr - CMC - Clear Lake Center - M-F, 8:00 AM - 5:00 PM **Webster, Texas, United States** Nursing & Care Management UTMB Health ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
    UTMB Health (12/12/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …you're not just taking a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management ... causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. + Participate regularly… more
    Beth Israel Lahey Health (12/14/25)
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  • Utilization Review Denials Nurse

    UNC Health Care (Kinston, NC)
    …support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established ... levels of an audit appeal. Works collaboratively with the Physician Advisors and subject matter experts for all audit...experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience… more
    UNC Health Care (11/20/25)
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  • RN Utilization Mgmt I

    Covenant Health Inc. (Knoxville, TN)
    …meetings between physicians and payors as applicable. + Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health. + ... Overview Registered Nurse Utilization Management Full Time, 80 Hours...physician advisors and facility departments as related to utilization management. Communicates with hospital and payor medical directors… more
    Covenant Health Inc. (12/18/25)
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  • Executive System Director of Utilization

    UNC Health Care (Morrisville, NC)
    …People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate and empower ... Guide physician engagement initiatives by developing training programs for physician advisors and advocating for evidence-based resource utilization 3.… more
    UNC Health Care (10/29/25)
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  • RN Utilization Manager - Rex Case…

    UNC Health Care (Raleigh, NC)
    …episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with… more
    UNC Health Care (12/24/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …each individual in the classification. + Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. + ... + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day...reviews and determine program improvements. + Develop and implement utilization review policies and procedures in accordance… more
    Alameda Health System (11/07/25)
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  • Utilization Management Specialist…

    Penn Medicine (Lancaster, PA)
    …life's work? **LOCATION:** Fully remote position after 12-week onsite orientation **HOURS:** Full Time (40 hours per week). Monday-Friday, one weekend every 11 ... Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for patients by… more
    Penn Medicine (12/24/25)
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