• Utilization Review RN

    Community Health Systems (Birmingham, AL)
    …management skills to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** The Care Manager - RN is responsible for coordinating and overseeing discharge...assess the appropriateness of admission, continued hospital stay, and utilization of diagnostic services. + Collaborates with interdisciplinary teams… more
    Community Health Systems (06/16/25)
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  • Hospice Registered Nurse RN

    Aveanna Healthcare (Bessemer, AL)
    Hospice Registered Nurse RN Part Time Weekdays ApplyRefer a FriendBack Job Details Requisition #: 205740 Location: Bessemer, AL 35022 Category: Nursing ... care and patient needs. + Participates in quality improvement, utilization review , and infection control activities as...takes corrective action. Qualifications: + Current license as a Registered Nurse in the State of Alabama… more
    Aveanna Healthcare (06/17/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Montgomery, AL)
    …- Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
    CVS Health (06/19/25)
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  • Case Manager, Registered Nurse

    CVS Health (Montgomery, AL)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (06/19/25)
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  • Regional Case Manager (Remote)

    Diversicare Healthcare Services & Diversicare Ther (Birmingham, AL)
    …patient management and satisfaction, promote continuity of care and cost effectiveness, utilization review and management as well as discharge planning. ... Residents' Lives!** Diversicare Healthcare Services is seeking an outstanding RN Case Manager that has a passion for providing...care plan. * The case manager provides center case management/ utilization review and discharge planning to assure… more
    Diversicare Healthcare Services & Diversicare Ther (06/04/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Clanton, AL)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (06/03/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Thomasville, AL)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (06/14/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Montgomery, AL)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
    Sharecare (05/10/25)
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  • RN Unit Manager

    NHS Management, LLC (Mobile, AL)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... medical plan! We are in search of a qualified RN Unit Manager : + Assists in maintaining resident...documentation of treatment and nursing observations. Qualifications: + Current RN license by State required with experience in the… more
    NHS Management, LLC (06/10/25)
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  • RN Supervisor

    NHS Management, LLC (Huntsville, AL)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... your life! We are in search of a qualified RN Shift Supervisor + Assists in maintaining resident care...documentation of treatment and nursing observations. Qualifications: + Current RN license by State required with experience in the… more
    NHS Management, LLC (06/19/25)
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  • RN Clinical Services Manager

    NHS Management, LLC (Vestavia Hills, AL)
    …of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. + Receives physicians' instructions regarding resident ... the way. We are in search of a qualified RN Clinical Services Manager: + Assists in maintaining resident...documentation of treatment and nursing observations. Qualifications: + Current RN license by State required with experience in the… more
    NHS Management, LLC (04/13/25)
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  • Assistant Vice President

    Sedgwick (Montgomery, AL)
    …to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines; and to ... provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the provision of these… more
    Sedgwick (05/23/25)
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  • Care Manager RN

    Highmark Health (Montgomery, AL)
    …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
    Highmark Health (06/19/25)
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  • Manager, Utilization Management

    Healthfirst (AL)
    …as assigned **Minimum Qualifications:** + Associates degree + New York State Registered Nurse + Work experience demonstrating verbal and written communication ... **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review ,… more
    Healthfirst (06/11/25)
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  • Care Manager RN

    Community Health Systems (Dothan, AL)
    …management skills to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... dialysis, nursing home, and home oxygen. Discharge planning includes daily review of the medical record, communication between nursing, physician, and therapy… more
    Community Health Systems (06/02/25)
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  • Clinical Reviewer, Nurse

    Evolent (Montgomery, AL)
    …Required and Preferred:** + Current, unrestricted state licensure as a Registered Nurse - **Required** + **California or Oregon License Required** ... , you will be a key member of the utilization management team. We can offer you a meaningful...+ Associate or Bachelors in Nursing (Must be a Registered Nurse ) - **Required** + You must… more
    Evolent (06/21/25)
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  • Facility Administrator

    Fresenius Medical Center (Montgomery, AL)
    …state regulations, and accrediting agency standards where applicable. + Participate in review business and finances of the site, including financial reports, market ... the security and integrity of facility + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply… more
    Fresenius Medical Center (06/14/25)
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