• Utilization Management

    Penn Medicine (Lancaster, PA)
    …pressure, we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible for evaluating medical records ... Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for… more
    Penn Medicine (12/24/25)
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  • Clinical Admissions Specialist

    Sanford Health (Fargo, ND)
    …department looking to expand the role of on-site clinical admission specialist , promoting home health services through education and referral recruitment. Must ... RN, OT, or PT license **Job Summary** Responsible for identifying potential admissions , the processing and placement of new resident/client requests and tracking… more
    Sanford Health (01/03/26)
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  • Utilization Management

    FLACRA (Clifton Springs, NY)
    Utilization Management Specialist FLACRA...the admissions process. + Contribute to bed management and utilization planning. + Monitor and ... $16.50 - $17.50/Hour Apply Now (https://flacra.jobs.net/apply/jqn6gn6t2h294xv9ngh?ipath=CR¬ify=true&siteid=cbnsv) Job Details Job Title: Utilization Management Specialist Location:Finger Lakes… more
    FLACRA (12/19/25)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
    LA Care Health Plan (12/20/25)
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  • PRN Clinical Utilization Review…

    Community Health Systems (Franklin, TN)
    …appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for...extended stays, identifying opportunities for process improvements to enhance utilization management . + Serves as a key… more
    Community Health Systems (12/03/25)
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  • Utilization Management

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay. This… more
    Mount Sinai Health System (01/02/26)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... What you will be doing? The Utilization Review (UR) Specialist is a...and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions ,… more
    BriteLife Recovery (01/05/26)
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  • Utilization Review RN - Patient Bus Svs

    St. Peters Health (Helena, MT)
    The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR team members in ... collaborative and supportive liaison and educator to providers and staff around utilization management principles. This professional role will be responsible… more
    St. Peters Health (12/11/25)
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  • Manager - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... financial, and utilization goals through effective management , communication, and...appropriate * Collaborates with department director and professional development specialist to develop standard work and expectations for the… more
    Minnesota Visiting Nurse Agency (12/06/25)
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  • Utilization Review Coordinator

    Community Health Systems (Franklin, TN)
    …reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case management software with documentation ... preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations.… more
    Community Health Systems (11/22/25)
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  • SLH Care Management Specialist

    Alameda Health System (San Leandro, CA)
    SLH Care Management Specialist + San Leandro, CA + San...years in a health care field or one year in Utilization Management at a Medical Group or Health ... classification. + Functions as a key point of contact between clinical case management staff, admissions and payors. Documents all interactions with payors and… more
    Alameda Health System (12/31/25)
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  • Patient Access Specialist (On-Site) (H)

    University of Miami (Miami, FL)
    …via in-basket messaging. + Extensive collaboration with providers, nursing unit, and utilization review department in coordinating admissions . CTU + Must possess ... sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Core Job Summary: The Patient Access Specialist (On-Site) is responsible for coordinating a wide range… more
    University of Miami (12/20/25)
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  • Commercial Review Specialist I

    SUNY Upstate Medical University (Syracuse, NY)
    …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... Job Summary: The UR-CR Specialist I is primarily responsible for ensuring that...This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients are… more
    SUNY Upstate Medical University (11/18/25)
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  • Assessment Specialist PRN

    HCA Healthcare (Nashville, TN)
    …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... to advocate for patients in regard to managed care organizations + Conducts utilization review for managed care cases in admissions /intake department +… more
    HCA Healthcare (11/10/25)
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  • Clinical Rehab Specialist PRN

    HCA Healthcare (Largo, FL)
    …Case Management and the Rehab Medical Director. The Clinical Rehabilitation Specialist works closely with hospital case management to ensure a responsive ... **Introduction** Do you have the PRN career opportunities as a(an) Clinical Rehab Specialist PRN you want with your current employer? We have an exciting opportunity… more
    HCA Healthcare (12/04/25)
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  • Patient Flow Specialist - Weekend Track-…

    Albany Medical Center (Albany, NY)
    …placement of admissions via all portals of entry, transfers, bed management , and overall throughput. Essential Duties and Responsibilities + Reports up through ... of America) Salary Range: $86,650.99 - $134,309.04 The Logistics Center Patient Flow Specialist is an integral component of the Logistics Center, as they help to… more
    Albany Medical Center (12/02/25)
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  • Clinical Inpatient Rehab Specialist RN OT…

    HCA Healthcare (Kissimmee, FL)
    …care like family! Jump-start your career as a(an) Clinical Inpatient Rehab Specialist today with HCA Florida Osceola Hospital. **Benefits** HCA Florida Osceola ... Come join our team as a(an) Clinical Inpatient Rehab Specialist . We care for our community! Just last year,...screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director. Job Duties and… more
    HCA Healthcare (11/10/25)
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  • Clinical Documentation Specialist RN

    Hackensack Meridian Health (Red Bank, NJ)
    admissions and observations as specified by the facility's Utilization Management /Review Committee for documentation completeness and compliance with ... and serve as a leader of positive change. The **Clinical Documentation Specialist RN** facilitates improvement in the overall quality, completeness and accuracy of… more
    Hackensack Meridian Health (12/05/25)
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  • Academic Student Support Program Specialist

    CUNY (New York, NY)
    …support for admissions , advising, financial aid, bursar, registrar, and learning management system inquiries and liaison with the Baruch One Stop Shop (BOSS) and ... Academic Student Support Program Specialist (Online Student Success Coach) **POSITION DETAILS** **"At Baruch College we believe that student success is everyone's… more
    CUNY (12/15/25)
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  • Pre-Arrival Authorization Specialist I

    UNC Health Care (Goldsboro, NC)
    …to Pre-Arrival Team Lead/Manager. 7. Notify Utilization Review & Case Management regarding any admissions that need Clinical Review. 8. Review/Sign/Commit to ... **Description** Summary: The Pre- Arrival Authorization Specialist I will serve patients/customers and physician offices by obtaining authorizations from insurance… more
    UNC Health Care (12/10/25)
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