• Clinical Appeals Specialist Medicare RN

    HCA Healthcare (Nashville, TN)
    …High School diploma or GED required; Associate's Degree preferred. + 1 year of Case Manager , Insurance utilization and/or hospital experience preferred. + ... invests in you as a Clinical Appeals Specialist Medicare RN or LPN? At Parallon, you come first. HCA...are looking for a dedicated Clinical Appeals Specialist Medicare RN or LPN like you to be a part… more
    HCA Healthcare (10/24/25)
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  • RN - Case Manager (WO)

    SSM Health (Jefferson City, MO)
    …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... management process, admission process, and act as a case manager liaison with post acute providers...Registered Nurse ( RN ) - Missouri Division of Professional… more
    SSM Health (09/12/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …Occasional + **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM ( Case Management) + Preferred CCM ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/ RN responsibilities include:** +... Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical… more
    BayCare Health System (10/10/25)
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  • LCSW/LMFT - Orange County

    Amergis (Orange, CA)
    Case Manager to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and ... Qualifications: + Current California unrestricted license such as LCSW, LPCC, LMFT or RN and related required education PLUS 3 years of clinical experience required;… more
    Amergis (08/14/25)
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  • RN , Care Manager

    Whidbey General Hospital (Coupeville, WA)
    …health, Hospice, skilled nursing, anti-biotic regime, etc. The RN - Care Manager follows the hospital's Case Management/ Utilization Plan that integrates ... regarding Utilization Review and Discharge Planning. The RN - Care Manager will lead an...+ Minimum of two years current experience as an RN in utilization review, case more
    Whidbey General Hospital (10/01/25)
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  • Supervisor, Utilization Management…

    LA Care Health Plan (Los Angeles, CA)
    …an enthusiastic team player. Must be able to work independently. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Supervisor, Utilization Management RN Job Category: Clinical...The Supervisor is a subject matter expert (SME) in Care/ Case / Utilization Management and supporting regulations, policies, protocols,… more
    LA Care Health Plan (10/14/25)
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  • Utilization Management Admissions Liaison…

    LA Care Health Plan (Los Angeles, CA)
    …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Utilization Management Admissions Liaison RN II...California License Licenses/Certifications Preferred Certified Case Manager (CCM) American Case more
    LA Care Health Plan (10/03/25)
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  • RN Case Manager

    HCA Healthcare (Savannah, GA)
    …Do you want to join an organization that invests in you as a Registered Nurse ( RN ) Case Manager ? At Memorial Health University Medical Center, in ... We are looking for a dedicated Registered Nurse ( RN ) Case Manager...management or critical care is preferred. + Certification in case management or utilization review is preferred.… more
    HCA Healthcare (09/21/25)
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  • Clinical Resource Manager

    Nuvance Health (Sharon, CT)
    …restore health to the patient. Responsibilities for this full time RN Case Manager position includes include utilization review, discharge planning and ... care transitions. Candidates require a CT state RN license, Bachelors Degree in Nursing or related field,...Nursing or related field, a minimum of 1 year Case Management experience in an acute care setting. CCM,… more
    Nuvance Health (10/22/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    … basis** **Introduction** Do you want to join an organization that invests in you as an RN Case Manager ? At HCA Florida Capital Hospital, you come first. HCA ... make a difference. We are looking for a dedicated RN Case Manager like you...required within 90 days of hire + Advanced Practice Registered Nurse license is acceptable for position… more
    HCA Healthcare (10/18/25)
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