• Intensive Community Care Manager , Registered…

    ChenMed (Largo, FL)
    …primary care physicians, and other members of the care team that provides hyperfocus case management and field nursing interventions to prevent unnecessary ... Once a patient has completed their episode of care management the register nurse (RN) will review...and evaluate individual patient care plans + Knowledge of nursing and case management theory… more
    ChenMed (10/02/25)
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  • Patient Care Management Coordinator

    Fairview Health Services (Minneapolis, MN)
    …Qualifications** + Bachelors Degree in Nursing + 1 year RN experience + Registered Nurse **Preferred Qualifications** + Case Management Nurse + Basic ... any unusual situations. Internal customers include all levels of nursing management and staff, medical staff, and...Mentors internal members of the health care team on case management and managed care concepts. +… more
    Fairview Health Services (12/16/25)
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  • Executive System Director of Utilization…

    UNC Health Care (Morrisville, NC)
    …Executive Director works closely with leaders from various departments- case management , physician advisors, revenue cycle, medical staff, nursing , and ... communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible for designing,… more
    UNC Health Care (10/29/25)
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  • Sr. Nurse Practitioner, Community Access…

    Johns Hopkins University (Baltimore, MD)
    …diseases testing and treatment, wound care, harm reduction services, and case management . We are seeking a **_Sr. Nurse Practitioner, Community Access & ... + Psychiatric nurse practitioner with years of experience in case management . + Experience in supervising multidisciplinary staff. + Knowledge… more
    Johns Hopkins University (12/10/25)
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  • Utilization Management Nurse

    US Tech Solutions (Hopewell, NJ)
    …services provided. 8. Encourages member participation and compliance in the case /disease management program efforts. 9. Documents accurately and comprehensively ... the use of intranet and internet applications. - Prefers working knowledge of case /care management principles. - Prefers working knowledge of principles of… more
    US Tech Solutions (10/24/25)
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  • Manager, Prior Authorization Utilization…

    CVS Health (Baton Rouge, LA)
    …a multidisciplinary team responsible for utilization review, prior authorization, and case management functions. + Monitor team performance, analyze metrics, ... it all with heart, each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical professionals to… more
    CVS Health (12/21/25)
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  • Director Pre Appeals Management -HSO…

    Mount Sinai Health System (New York, NY)
    …outcomes while controlling costs. The Director collaborates closely with medical staff, vendors, case management , and payers to secure payment and benefits for ... the clinical care provided. **Qualifications** + Bachelor?s degree in Nursing (BSN) or related healthcare field required + Master?s...in the state of employment required + Certification in Case Management (CCM, ACM) or Utilization … more
    Mount Sinai Health System (11/01/25)
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  • Care Manager RN - Utilization Management

    Highmark Health (Harrisburg, PA)
    …resource utilization, identification of opportunities for referral to a Health Coach/ case management , and identification and resolution of quality issues. ... and refer members whose healthcare outcomes might be enhanced by Health Coaching/ case management interventions. + Employ collaborative interventions which focus,… more
    Highmark Health (12/18/25)
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  • Director, Utilization Management & Prior…

    Fallon Health (Worcester, MA)
    …member care within Care Services as well as other departments by involving inpatient case management with out-patient case management and utilization ... With the general direction from the VP Sr. Medical Director Clinical Management and SVP/Chief Medical Officer will provide strategic leadership and oversight… more
    Fallon Health (12/14/25)
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  • Senior Community Health Nurse

    MyFlorida (Jacksonville, FL)
    …of control measures, specimen collection, testing and vaccination, vaccine coordination, case management , community outreach, education, linkage to care and ... SENIOR COMMUNITY HEALTH NURSE - 64003557 Date: Dec 11, 2025 The...prevention and recommends appropriate courses of action. Carries out case management activities, including referrals to community… more
    MyFlorida (12/13/25)
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