- 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
- State of Indiana (Indianapolis, IN)
- …of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the purpose ... Utilization Management Manager Date Posted: Nov 30, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling… more
- Houston Methodist (Houston, TX)
- …+ Five years of hospital clinical nursing experience, which includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position...to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... for case management scope of services including: Utilization Management services supporting medical necessity and...level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... access the full range of their benefits through the utilization review process. + Conducts admission reviews....degree such as nursing, social work, psychology, health information management or other related healthcare field is preferred or… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
- Elevance Health (Tampa, FL)
- …is granted as required by law. *Must reside in the state of Florida* The ** Manager of Utilization Management ** is responsible for managing a team of ... practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure cost effective … more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236088/rn-case- manager utilization - ... and service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more
- Community Health Systems (Franklin, TN)
- …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... Nursing preferred + 2-4 years of clinical experience in utilization review , case management , or...Compact State Licensure required + CCM - Certified Case Manager preferred or + Accredited Case Manager … more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... review for medical necessity and decision-making. The Nurse 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