- UNC Health Care (Raleigh, NC)
- **Description** ** RN Utilization Manager needed to provide per diem coverage on weekends at UNC Rex and UNC Rex Holly Springs.** Become part of an inclusive ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- UNC Health Care (Hendersonville, NC)
- …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...Required + Must be licensed to practice as a Registered Nurse in the state of North… more
- Tufts Medicine (Burlington, MA)
- …minimizing cost, and ensuring optimum outcomes. **Job Description** **Minimum Qualifications:** 1. Registered Nurse (BSN or higher) or other licensed clinical ... assisting with the coordination of the Utilization Management Committee. The Utilization Management Operations Manager follows the system's Utilization … more
- Commonwealth Care Alliance (Boston, MA)
- …procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and managing the ... daily operation of the Utilization Management Review Nurse and Specialist staff...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to the Director… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management, you will be...resource for navigating post-acute care services. **Minimum Qualifications:** + RN licensed by the State of Maryland or Compact… more
- Children's Hospital Boston (Boston, MA)
- … Utilization Management) preferred. Licensure/ Certifications: + Current Massachusetts license as a Registered Nurse ( RN ) + A certification as a Certified ... 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care… more
- LifePoint Health (Gallatin, TN)
- …or related healthcare field. **Job:** **Nursing* **Organization:** ** **Title:** * Utilization Mgmt Case Manager FT* **Location:** *Tennessee-Gallatin* ... Monitors adherence to the hospital's utilization review plan to ensure appropriate use of...- Case Management Minimum Education Associate's, Bachelor's degree or RN Diploma in Nursing - Required Required Skills Requires… more
- Beth Israel Lahey Health (Burlington, MA)
- … Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager for Hospital at Home Care Transitions coordinates ... to meet the needs of the department. **Minimum Qualifications:** Education: * Registered Nurse , Bachelors Degree or commensurate experience preferred. Licensure,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Central Maine Medical Center (Lewiston, ME)
- …for our community and for each other every day. Position Summary: The Utilization Management Nurse is responsible for a comprehensive clinical review to ... RN licensure.*Three (3) or more years of previous experience in Utilization Management and/or Care Management.*BSN preferred.Certified Case manager required… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …initiatives/opportunities for improvement through departmental committee assignments. Qualifications: + Registered Nurse or Licensed Practical Nurse . ... healthcare needs of the patients using the functions of Utilization Resource Management, Transition of Care, Discharge Planning, and...+ Current and valid license to practice as a Registered Nurse or Licensed Practical Nurse… more
- Prime Healthcare (Ontario, CA)
- …of nursing and a current state Registered Nurse license. + Minimum 3 years RN Utilization Manager working for a Health Plan. + At least 3 years of ... Status Full Time Shift Days Connect With Us! (https://careers-primehealthcare.icims.com/jobs/211752/ utilization -review- rn /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management Inc LocationUS-CA-Ontario… more
- Ascension Health (Baltimore, MD)
- …job transfer date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date ... required. Education: + Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required. **Additional Preferences** \#ATP **Why Join Our Team** Ascension associates are key to our commitment of… more
- Prime Healthcare (Weslaco, TX)
- …Full Time Shift Days Connect With Us! (https://careers-primehealthcare.icims.com/jobs/210205/ registered - nurse -case- manager utilization ... -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityKnapp Medical Center LocationUS-TX-Weslaco ID2025-210205 CategoryClinical Professional Position TypeFull Time ShiftDays Job TypeNon-Exempt more
- Ascension Health (Appleton, WI)
- …and evaluation of staff. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Wisconsin Board of Nursing obtained ... **Details** + **Department:** Utilization Management + **Schedule:** Full Time, Day Shift...at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- Beth Israel Lahey Health (Burlington, MA)
- …Degree, Master's Degree preferred **Licensure, Certification, Registration:** Current license as a Registered Nurse **Skills, Knowledge & Abilities** : + Current ... a job, you're making a difference in people's lives.** Manages the Utilization Management (UM) team, maintaining effective and efficient processes for determining… more
- Ascension Health (Pensacola, FL)
- …evaluation of staff. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Department of Health ... **Details** + **Department: Utilization Review** + **Schedule: Full time days** +...at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- Healthfirst (IA)
- …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...Excel, Word, Power Point and Outlook **Preferred Qualifications:** + RN , LPN, LMSW, LMHC, LCSW, or any other relevant… more
- Children's Mercy Kansas City (Kansas City, MO)
- …experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including...+ One of the following: Licensed RN - Kansas, Registered Nurse … more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more