• Registered Nurse - Clinical Documentation…

    Cedars-Sinai (Los Angeles, CA)
    …Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of Joint ... for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8 Hour Days **Department** : CSRC CDI Services… more
    Cedars-Sinai (06/19/25)
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  • Nurse Practitioner (Acute Care), Physician…

    Cleveland Clinic (Cleveland, OH)
    Acute Care Nurse Practitioner Certification (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner Certification (AG ACNP) Tertiary/Quaternary Facility ICU ... for the patient while working in the team environment with the Registered Nurse or Paramedic. - Assessing, stabilizing, and managing critically ill and injured… more
    Cleveland Clinic (07/18/25)
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  • RN Utilization Management Openings - Apply…

    Amergis (Rancho Cordova, CA)
    Utilization Management. Apply today to learn more about the current opportunities! The Utilization Review Specialist is responsible for theassessment and ... + Current license for the state in which the nurse practicesif nursing licensure is required by contract +...Degree in Nursing or at least two years'experience in Utilization Review preferred + Certification in … more
    Amergis (07/03/25)
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  • UR Clinical Specialist

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
    Community Health Systems (07/09/25)
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  • Insurance Specialist - Samaritan Hospital…

    Trinity Health (Troy, NY)
    …requirements for Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse , physicians, staff and ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management/Concurrent Review Nurse within identified… more
    Trinity Health (06/14/25)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... Integra Partners is seeking an experienced nurse educator to join our Operations Training &...Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes.… more
    Integra Partners (06/03/25)
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  • Enhanced Care Management Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …and unrestrited California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Enhanced Care Management Clinical Specialist II Job Category: Clinical Department: Care Management...Light Additional Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM),… more
    LA Care Health Plan (07/16/25)
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  • Registered Nurse (RN), Clinical Case…

    LifePoint Health (Hickory, NC)
    …execution, adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care and ... *Registered Nurse (RN), Clinical Case Manager* PRN * *...Commission, OSHA, CMS, HCFA, AHCA). * Mentors staff on Utilization Review (UR) standards and Length of… more
    LifePoint Health (07/16/25)
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  • Clinical Rehab Specialist PRN

    HCA Healthcare (Richmond, VA)
    …acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong ... commitments to referral sources. Develops a call-plan to prioritize utilization of time.** + **Assists in developing the annual...we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications.… more
    HCA Healthcare (06/21/25)
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  • Medical Certification Specialist 1-2

    Louisiana Department of State Civil Service (LA)
    Medical Certification Specialist 1-2 Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4818520) Apply  Medical Certification Specialist 1-2 ... of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner. LDH serves as a… more
    Louisiana Department of State Civil Service (05/07/25)
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