• Behavioral Health Utilization Review

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... in utilization management, behavioral health, and mental health. + Proficiency in clinical and utilization review processes. + Current unrestricted Florida RN… more
    Actalent (10/10/25)
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  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of ... the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care,… more
    UNC Health Care (09/04/25)
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  • Registered Nurse - Utilization…

    Beth Israel Lahey Health (Plymouth, MA)
    …data to establish the appropriate level of care using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal ... the care provided to the hospitalized patient. + Conducts concurrent reviews to determine the continued need for acute...degree in healthcare preferred. + Three years recent, broad clinical experience in the hospital setting + Experience with… more
    Beth Israel Lahey Health (08/16/25)
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  • Quality & Patient Safety Specialist - Registered…

    Beth Israel Lahey Health (Cambridge, MA)
    …reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement ... + Reviews medical records to collect data for reporting quality measures, including both concurrent medical record review and periodic medical record review more
    Beth Israel Lahey Health (08/08/25)
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  • Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
    Community Health Systems (10/14/25)
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  • Nurse Educator, Cardiac Cath & EP Lab

    Baystate Health (Springfield, MA)
    …growth, role competence and proficiency in their specialty.** + The Nurse Educator facilitates the achievement of professional/ clinical outcomes with ... BH model of patient care. + In collaboration with clinical managers and quality leaders, the Nurse ...of Nursing Professional Development and encourages the advancement of clinical nursing practice and professional development through review more
    Baystate Health (10/01/25)
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  • Trauma Nurse

    UHS (Johnson City, NY)
    …registry by working closely with the TPM and Trauma Registrars to assure accurate, concurrent clinical data abstraction and entry into the trauma registry. The ... Position OverviewThe Trauma Resource Nurse (TRN) has responsibility for concurrent ...to assure the provision of safe, efficient and effective clinical care to all injured patient by continuously monitoring,… more
    UHS (07/24/25)
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  • Patient Safety Coordinator Registered Nurse

    HCA Healthcare (Portsmouth, NH)
    …to you, we encourage you to apply for our Patient Safety Coordinator Registered Nurse opening. Our team will promptly review your application. Highly qualified ... Join our Team as a Patient Safety Coordinator Registered Nurse and access programs to assist with every stage...lead, coordinate and carry out an assigned portfolio of clinical quality and patient safety functions to support the… more
    HCA Healthcare (08/01/25)
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  • RN - Registered Nurse Case Manager - Trauma

    Geisinger (Wilkes-Barre, PA)
    …priorities. Some of those responsibilities include, but are not limited to, daily review of the clinical management guidelines for each patient, direct patient ... Trauma Case Manager will also round with the trauma clinical team. Job Duties The RN Case Manager Trauma...Trauma Registry. + Maintains trauma roster and updates on concurrent basis. + Summarizes concurrent daily chart… more
    Geisinger (07/24/25)
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  • Nurse , Care Management

    Alameda Health System (San Leandro, CA)
    …utilization review functions, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal ... Nurse , Care Management + San Leandro, CA +...develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative levels of care,… more
    Alameda Health System (10/15/25)
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