• Sepsis Coordinator

    AdventHealth (Kissimmee, FL)
    …of care systems and assures compliance with quality measures through concurrent and retrospective review , identification of deficiencies, and implementing ... for improvement as a content expert. + Collaborates with Nurse Managers and Directors prior to execution and considers...experience + 5 in acute care setting + Registered Nurse (RN) + Basic Life Support - CPR Cert… more
    AdventHealth (11/21/25)
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  • RN Case Manager

    HCA Healthcare (Thornton, CO)
    …quality patient care with the cost effective utilization of resources. Performs concurrent clinical review to determine appropriateness of admission and ... licensure in the State of Colorado as a Registered Nurse , or current active multistate Registered Nurse ...Registered Nurse , or current active multistate Registered Nurse license. Current AHA or ARC BLS certification required.… more
    HCA Healthcare (11/16/25)
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  • RN Case Manager

    HCA Healthcare (Panama City, FL)
    …to appropriate agencies and third party payers regarding pre-admission screening, concurrent , outpatient and retrospective review process as it relates ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...compact license required within 90 days of hire. Advanced Nurse Practitioner license acceptable + 5 years Case Management… more
    HCA Healthcare (11/10/25)
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  • Case Manager RN - Enhanced Care Management

    Prime Healthcare (Victorville, CA)
    …and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, ... Voluntary Benefit Options! (https://www.primehealthcare.com/careers/benefits/) Responsibilities The Case Manager Registered Nurse (CMRN) works collaboratively as part of the ECM… more
    Prime Healthcare (10/31/25)
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  • Clinical Reimbursement Coordinator, RN

    Genesis Healthcare (Albuquerque, NM)
    …of the MDS assessments including case-mix, OBRA and OSRA required assessments. *Perform concurrent MDS review to insure appropriate RUGs category is achieved ... Overview **Ladera Care Center seeks a part time MDS Nurse !** At Genesis Healthcare, we are dedicated to improving...impact in the communities we serve. Responsibilities The MDS Nurse -- RN manages the overall process and tracking… more
    Genesis Healthcare (10/29/25)
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  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …an effective in-patient Care Management program that includes initial and concurrent review ; case management/discharge planning activities. Responsible for ... 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's...preferably in a managed care setting + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED… more
    Sharp HealthCare (10/07/25)
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  • Professional, Behavioral Health

    MVP Health Care (Tarrytown, NY)
    …. The Behavioral Health (BH) Professional is responsible for conducting utilization review for mental health and substance use treatment decisions. This individual ... and licensed mental health clinician (LMSW, LCSW, LMHC, etc.) or Licensed Registered Nurse (RN) required + New York State license required + Licensed Behavior… more
    MVP Health Care (11/27/25)
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  • Medical Management Clinician Sr.

    Elevance Health (Ashburn, VA)
    …relatively complex case types that require the training and skill of a registered nurse . Acts as a resource for more junior Clinicians. **Primary duties may include ... clinical guidelines within scope of licensure. These reviews may require in-depth review ; however, any deviation from application of benefits plans will require… more
    Elevance Health (11/26/25)
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  • RN Appeals Reviewer

    Adecco US, Inc. (Minneapolis, MN)
    …applying benefits and criteria to clinical reviews . Utilization Management, pre-authorization, concurrent review , or appeals experience **Why work for Adecco?** ... rendering approvals when appropriate. . You will summarize medical information for review by the Medical Director as needed, ensuring a balance between high-quality… more
    Adecco US, Inc. (11/21/25)
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  • RN Case Manager PRN

    Nuvance Health (Norwalk, CT)
    …are executed to the appropriate level within the care continuum. Provides clinically based concurrent review of the medical record to assess and procure accurate ... liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and medical records to ensure appropriate status is assigned.… more
    Nuvance Health (11/13/25)
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