• RN, Hospital Case Manager

    Baystate Health (Springfield, MA)
    …Minimum - Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management** The **RN Hospital Case Manager ** is a ... of a designated population of patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...+ Requires a working knowledge of community resources and Utilization /Quality Review standards and activities conducted by… more
    Baystate Health (12/19/25)
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  • Utilization Management - Nurse…

    Sanford Health (Rapid City, SD)
    …Schedule:** Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a ... while optimizing value across the care continuum. You'll shape and execute utilization strategies that become the standard for how we coordinate care, authorize… more
    Sanford Health (12/17/25)
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  • RN Utilization Review - Full-time…

    Providence (Irvine, CA)
    **Description** **RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, retrospective, ... and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as… more
    Providence (01/01/26)
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  • RN Utilization Review Part- time Day

    Providence (Mission Hills, CA)
    **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... utilization reviews for our LA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the health… more
    Providence (12/19/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... + Preferred ACM (Case Management) + Preferred CCM (Case Manager ) **Education:** + Required Associates in Nursing or +...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (10/10/25)
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  • Utilization Manager -OASAS Program

    Samaritan Daytop Village (Rhinebeck, NY)
    …and goal of sustaining high quality care/service delivery to persons served, the Utilization Manager works to assist CASAC Counselors and supervisory staff as ... needed with assuring compliance with external and internal utilization review /quality and appropriateness requirements. What qualifications do you need: +… more
    Samaritan Daytop Village (12/06/25)
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  • Director, Organ Utilization

    LifeCenter Northwest (Bellevue, WA)
    …a culture of collaboration, accountability, and continuous improvement across the organ utilization function. + Mentors and develops the manager (s) and lead ... Salary Position Type Full Time Description and Qualifications The Director, Organ Utilization (Director), is responsible for overseeing the processes and teams that… more
    LifeCenter Northwest (11/21/25)
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  • Utilization Management Nurse Specialist RN…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically… more
    LA Care Health Plan (12/20/25)
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  • Registered Nurse (RN) - Utilization

    Rochester Regional Health (Rochester, NY)
    …able to work independently with minimum direction. + Act as a resource for utilization review stakeholders and assists team members in clinical problem solving. ... Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per...standard UM sources for potential inpatient medical necessity denials. Review patient class in the event manager ,… more
    Rochester Regional Health (12/31/25)
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  • Case Manager - Utilization

    Prime Healthcare (Sherman Oaks, CA)
    …With Us! (https://careers-primehealthcare.icims.com/jobs/239073/case- manager - utilization -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
    Prime Healthcare (12/30/25)
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