• Manager - Utilization Review & Denials…

    Beth Israel Lahey Health (Plymouth, MA)
    …, health care administration or related field preferred or commensurate experience and Case Management Certification required + Minimum of 3 years of progressive ... lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At...**In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance regarding… more
    Beth Israel Lahey Health (12/14/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Harrisburg, PA)
    …Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... clinical intervention for each member. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care… more
    Highmark Health (12/04/25)
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  • Nurse Care Manager 1

    Rush University Medical Center (Chicago, IL)
    …pediatric, adolescent, adult and /or geriatric patient, and expert knowledge in case management , discharge planning, social service, and criteria application. ... Offers may vary depending on the circumstances of each case . **Summary:** The Nurse Care Manager 1...1. Functions as an expert clinical practitioner within the Case Management team and serves as a… more
    Rush University Medical Center (12/18/25)
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  • Bilingual RN- Telephonic Care Management

    Humana (San Juan, PR)
    …overtime and/or weekends) **Preferred Qualifications** + Health Plan experience + Previous Case Management Experience + Call center or triage experience + ... appropriate for their care and wellbeing. The Care Manager, Telephonic Nurse 's work assignments are varied and frequently require interpretation and independent… more
    Humana (10/16/25)
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  • Acute Care Manager (RN)

    ChenMed (Philadelphia, PA)
    …+ Ability to plan, implement and evaluate individual patient care plans + Knowledge of nursing and case management theory and practice + Knowledge of patient ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning… more
    ChenMed (10/24/25)
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  • Program Operations Manager - Inpatient Care…

    University of Washington (Seattle, WA)
    …and clinical expertise in the care of acute care patients. Minimum 3 years Case Management or discharge planning experience specifically in relation to patients ... has an outstanding opportunity for a **Program Operations Manager with Inpatient Care Management .** **WORK SCHEDULE** * Full-Time / 40 hours per week * Day Shift… more
    University of Washington (12/18/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …of three years clinical experience in an assigned service.* Recent experience in case management , utilization management and/or discharge planning/home care ... in a high volume, acute care hospital preferred. PRI and* Case Management certification preferred.* Assertive and creative in problem solving, critical thinking… more
    Albany Medical Center (12/03/25)
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  • Nurse Manager - VA Community Care

    Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
    …will have a national nursing certification, with relevant certification in Nurse Executive, Case Management or other certification. Experience in ... surgical, or specialty care experience, to include direct patient care and/or case management /care coordination. Preferred candidate will have 1-2 years of… more
    Veterans Affairs, Veterans Health Administration (12/19/25)
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  • Assistant Nursing Director, Administration

    The County of Los Angeles (Los Angeles, CA)
    …in clinical nursing . + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL REQUIREMENT INFORMATION: *In order to receive credit ... Nurse issued by the California Board or Registered Nursing .* Applicantsmustensure the License and Certification Section of the...appropriateness of the level of care. For this examination, Case Management is a collaborative process that… more
    The County of Los Angeles (10/18/25)
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  • RN Behavioral Health - Care Manager

    Molina Healthcare (Louisville, KY)
    …. Bachelor's Degree in Nursing preferred. **Required Experience** 1-3 years in case management , disease management , managed care or medical or behavioral ... For this position we are seeking a (RN) Registered Nurse who lives in Kentucky and must be licensed...in Nursing **Preferred Experience** 3-5 years in case management , disease management , managed… more
    Molina Healthcare (11/02/25)
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