- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …care coordination, and transition of care between settings. Required Skills and Experience * Registered nurse with current MN license and with no restrictions. * ... Cross and Blue Shield of Minnesota Position Title: Care Advocacy Case Manager RN - Bilingual Spanish Location: Remote Career Area: Health Services About Blue Cross… more
- UnityPoint Health (Cedar Rapids, IA)
- …with thrird party payers regarding authorization of stay, continued stay reviews, appeals and denial letters. + Provides education and serves as a resource ... self-management and health care decision-making. Qualifications + State of Iowa Licensed RN + Two years of behavioral health work experience. + Professional… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** RN /Case Manager MSH Case Management PT Days** The Case Manager (CM) will be responsible for all aspects of case management for an assigned ... experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred....or a minimum of 3-5 years experience as a RN in an acute care setting **Certification Requirements:** Current… more
- State of Colorado (Denver, CO)
- …Support NA 01 A requirement of the position is that you possess and maintain a VALID Registered Nurse ( RN ) License issued by the State of Colorado or any ... a license. As an example, if you are a registered nurse with a multistate license from...and other disciplines. + Directs and consults with other RN III's and subordinate staff in their provision of… more
- UNC Health Care (Kinston, NC)
- …+ Minimum 3-5 years of applied clinical experience as a Registered Nurse required. + 2 years utilization review , care management, or compliance experience ... the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established criteria… more
- CVS Health (Baton Rouge, LA)
- …Lead, coach, and develop a multidisciplinary team responsible for utilization review , prior authorization, and case management functions. + Monitor team performance, ... day-to-day workflow, workload allocation, and coverage to ensure timely case review and resolution. + Drive process improvement initiatives that enhance efficiency,… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience ... providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff… more
- University of Southern California (Arcadia, CA)
- …cost per case, excess days, resource utilization, readmission rates, denials, and appeals . + Collaborates and communicates with multidisciplinary team in all phases ... continuous improvement in both areas. + Perform 100% UR Review on all Medicare One-Day admissions. + Proactively identifies.... Licenses and Certifications Minimum (Required) * A current RN licensure in the State of California is required.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM ... + + + + Introduction Are you an experienced Registered Nurse looking to make a difference...learn more about joining our team as a Utilization Review Nurse Coordinator! The State of Connecticut… more
- Children's Mercy Kansas City (Kansas City, MO)
- …experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire ... oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient...+ One of the following: Licensed RN - Kansas, Registered Nurse … more