• Case Review Specialist

    City of New York (New York, NY)
    …Support Services (OCSS) is recruiting four (4) Clerical Associate III's, functioning as Case Review Specialists, Under supervision of the Unit Supervisor of Data ... latitude for independent judgment, the Clerical Associate III, functioning as Case Review Specialist, is responsible for reviewing reports to correct and… more
    City of New York (10/25/25)
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  • Case Review Analyst

    CAI (Newark, DE)
    Case Review Analyst **Req number:** R6179 **Employment type:** Full time **Worksite flexibility:** Onsite **Who we are** CAI is a global technology services firm ... we are trailblazers in bringing neurodiversity to the enterprise. **Job Summary** As the Case Review Analyst, you will review cases completed by case more
    CAI (11/19/25)
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  • Director - Case Management Medical…

    Lilly (Indianapolis, IN)
    …determined to make life better for people around the world. **Purpose:** The Case Management Medical Review Scientist is responsible for conducting comprehensive ... medical review of Individual Case Safety Reports (ICSRs), ensuring the accuracy, integrity, and...regulatory guidance to cross-functional teams to enable completion of case management and medical review work. +… more
    Lilly (11/13/25)
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  • Utilization Review Specialist Nurse (RN)…

    Houston Methodist (Houston, TX)
    …of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed...coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the… more
    Houston Methodist (11/02/25)
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  • Medicaid Quality Control Case Review

    City of New York (New York, NY)
    …for (1) one Principal Administrative Associate, who will function as a Medicaid Quality Control Case Review Supervisor who will: - Review the audit findings ... review of completed assignments to ensure consistency in case error finding methodology. - Train and update Quality...capture the elements necessary to assist the Quality Control Case Reviewers in their eligibility review findings.… more
    City of New York (11/05/25)
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  • Utilization Review Case Mgr - CMC…

    UTMB Health (Webster, TX)
    Utilization Review Case Mgr - CMC - Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2506588 The ... in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively assessing the clinical… more
    UTMB Health (11/21/25)
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  • Utilization Review Case Manager

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... retrospective review of inpatient admissions and services. This position will...This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process… more
    Dallas Behavioral Healthcare Hospital (10/30/25)
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  • RN Case Manager - Utilization Review

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn- case -manager utilization- review ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
    Prime Healthcare (11/27/25)
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  • Workers Compensation Nurse Case Manager

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    … Management services for Workers' Compensation. The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, ... and disability services for timely return to work. + Provides case management, utilization review , continued stay reviews, and based on clinical judgment and… more
    Brighton Health Plan Solutions, LLC (10/24/25)
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  • Support Services Liaison: Case Worker,…

    New York State Civil Service (New York, NY)
    …No Agency Attorney General, Office of the Title Support Services Liaison: Case Worker, Labor Bureau (6409) Occupational Category Legal Salary Grade NS Bargaining ... New York State Attorney General's (OAG) is seeking experienced case workers, or similarly qualified individuals, to serve as...needed, please include a cover page to provide the reviewer with any relevant context or background information. *… more
    New York State Civil Service (10/31/25)
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