• Utilization Review Clinician

    Monte Nido (Miami, FL)
    …to provide comprehensive care within an intimate home setting. We are seeking a Utilization Review Clinician to join our team based Remotely. **This is a ... while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been… more
    Monte Nido (08/28/25)
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  • Manager, Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome focused family ... of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient… more
    Children's Mercy Kansas City (06/17/25)
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  • Utilization Review Case Manager

    Dartmouth Health (White River Junction, VT)
    Utilization Review Case Manager - Home Health .6 FTE/24 per Week, Days Why work as a Utilization Review Case Manager at Visiting Nurse and Hospice ... you'll become part of a dedicated team delivering outstanding home health and hospice services that enrich the lives...that enrich the lives of the people we serve. Utilization Review Case Managersat VNH focus on… more
    Dartmouth Health (08/26/25)
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  • Utilization Review Specialist Sr.

    BayCare Health System (Tampa, FL)
    …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... the Tampa Bay area. Our network consists of 16 community- based hospitals, a long-term acute care facility, home...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (08/26/25)
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  • Utilization Review Spec Sr

    BayCare Health System (Clearwater, FL)
    …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... the Tampa Bay area. Our network consists of 16 community- based hospitals, a long-term acute care facility, home...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (08/22/25)
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  • Utilization Management Nurse - Front End…

    Humana (Tallahassee, FL)
    …part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
    Humana (08/27/25)
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  • Utilization Review RN Case Manager…

    Penn Medicine (Philadelphia, PA)
    …or Equivalent Experience: + Bachelor of Arts or Science (Required) + Utilization Review experience (Required) + Bachelor's Degree in Nursing required.2+ ... interdisciplinary care team and Physician Advisor, with timely coordination of home care, DME, placements, hospice, community resources, transportation, and quality… more
    Penn Medicine (08/19/25)
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  • Utilization Review RN

    Ascension Health (Murfreesboro, TN)
    …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (08/28/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Boise, ID)
    …(RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active and ... evidenced based clinical criteria and clinical practice guidelines. Med Review nurses use specific criteria to authorize procedures/services or initiate a… more
    CVS Health (08/15/25)
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  • Outcomes Manager, Utilization Review

    Virtua Health (Pennsauken, NJ)
    …the latest technologies, treatments, and techniques to provide exceptional care close to home . A Magnet-recognized health system ranked by US News and World Report, ... our Eat Well food access program (https://www.virtua.org/about/eat-well) , telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient… more
    Virtua Health (08/26/25)
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