• Utilization Management Nurse Consultant…

    CVS Health (Columbus, OH)
    …role in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position ... in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital… more
    CVS Health (09/20/25)
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  • Clinical Coordinator, Case Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …& entry, clinical intake screening assessment, and effectively communicating with Nurse Case Managers. The Clinical Coordinator reports to the Manager, Case ... Case Management / Medical Management services to its clients. Clinical Coordinator facilitates case management by performing intake and...GED is required. + Strong skills in medical record review . + Familiarity with medical terminology a plus. +… more
    Brighton Health Plan Solutions, LLC (08/13/25)
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  • Clinical Risk Manager

    Mount Sinai Health System (New York, NY)
    …preferred. + Current New York State license as a Registered Professional Nurse or other licensed/certified clinical professional strongly preferred; foreign ... of Risk Management, conducts investigations, which includes assessing need for focused review by departments, and or clinical chairpersons for peer reviews.… more
    Mount Sinai Health System (09/17/25)
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  • Clinical Operations Specialist - Must…

    Wellpath (Beaumont, TX)
    …for training, education, and point of care support. **About this role** The Clinical Operations Specialist is a Registered Professional Nurse with advanced ... a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We...expertise in correctional nursing and administration of nurse services. The role involves providing guidance to operational… more
    Wellpath (09/16/25)
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  • RN Registered Nurse Patient Safety/Peer…

    Penn State Health (Reading, PA)
    …processes to improve reliability of systems. Accountable for medical staff peer review coordination to support medical staff clinical quality professional ... status, and family medical or genetic information._ **Position** RN Registered Nurse Patient Safety/Peer Review /Mortality - Quality Services **Location**… more
    Penn State Health (09/06/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... in nearly every medical specialty and subspecialty. In addition to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the… more
    The County of Los Angeles (06/28/25)
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  • Clinical Donation Coordinator

    Sharing Hope SC (North Charleston, SC)
    …Range Undisclosed Travel Percentage Road Warrior Job Shift Rotating Shift Job Category Nurse Description Summary The Clinical Donation Coordinator I (CDC I) ... Clinical Donation Coordinator - Charleston Job Details Level...(CDC) guidelines and recommendations. + Completes hospital medical record review , including history of present illness and past medical… more
    Sharing Hope SC (08/20/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    clinical policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. + Reviews ... and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. + Considers all documented...Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions… more
    US Tech Solutions (07/18/25)
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  • Accreditation Program Coordinator

    HCA Healthcare (Austin, TX)
    …Austin Medical Center.** **Preferred: Computer skills** **EDUCATION AND EXPERIENCE** **:** **Required: Clinical Background - Registered Nurse with a minimum of ... The APC is responsible for all program management, report generation and review , process improvement, patient satisfaction, facilities review , and administrative… more
    HCA Healthcare (08/22/25)
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  • Clinical Risk Manager - Risk Management…

    Mount Sinai Health System (New York, NY)
    …preferred. + Current New York State license as a Registered Professional Nurse or other licensed/certified clinical professional strongly preferred; foreign ... Cause Analysis investigations, which includes assessing need for focused review by departments, and or clinical chairpersons...for focused review by departments, and or clinical chairpersons for peer reviews. 5. Maintains risk management… more
    Mount Sinai Health System (07/12/25)
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