• Per Diem RN Case Manager

    Children's Hospital Boston (Boston, MA)
    80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management /ReviewDepartment:Patient Services-Patient Care ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Licensure/ Certifications: + Current Massachusetts license as a… more
    Children's Hospital Boston (06/16/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance regarding UR and… more
    Beth Israel Lahey Health (07/29/25)
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  • Manager , Case Management

    Seattle Children's (Seattle, WA)
    …experience caring for children with medical complexity Current or previous hospital case management or utilization review experience Current or previous case ... Using Seattle Children's leadership qualities and values-based behaviors the manager is accountable for achieving goals and key performance... management or utilization review leadership experience **Compensation Range** $115,277.00… more
    Seattle Children's (06/17/25)
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  • Utilization Management Reviewer

    Commonwealth Care Alliance (Boston, MA)
    Management Reviewer reports to the Utilization Management Manager . * Conducts timely clinical decision review for services requiring prior ... review for medical necessity and decision-making. The Utilization Management Reviewer has a key role...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy * Works… more
    Commonwealth Care Alliance (07/31/25)
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  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management ** and ** Utilization ... CCM, ACM, or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management ** This role is ideal… more
    Beth Israel Lahey Health (07/03/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • Care Manager RN - Utilization

    Providence (Napa, CA)
    **Description** Care Manager RN - Utilization Review unit at Providence Queen of the Valley Medical Center in Napa, CA. This position is Full-Time and will ... the utilization of appropriate health care services. Position may require Utilization Management and Discharge Planning, Chronic Disease Case Management more
    Providence (08/08/25)
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  • Manager , Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …development of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...of hire + One of the following: American Case Management , Certified Case Manager required upon hire… more
    Children's Mercy Kansas City (06/17/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As ... + Posted:Yesterday **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN...in orientation of fresh staff as requested by the Manager of Utilization Management . 17.… more
    Alameda Health System (08/22/25)
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  • Utilization Review Nurse - Case…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,...state, local, and federal programs + Progressive knowledge of utilization management , case management , performance… more
    Houston Methodist (07/12/25)
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