• Regional Case Manager

    NHS Management, LLC (Tuscaloosa, AL)
    …in accordance with the assessment and the plan of care. QUALIFICATIONS + Must be a Registered Nurse in good standing in the state(s) in which assigned + Must be ... MDS (minimum data set) experience required. RAC certified highly desired! Are you a RN with at least one year of MDS Coordinator experience? Looking for an… more
    NHS Management, LLC (11/26/25)
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  • Nurse Practitioner

    Sacramento County (Sacramento, CA)
    …Employment Qualifications Minimum Qualifications Possession of a current valid license as a Registered Nurse and a Nurse Practitioner certification issued by ... of health care services involving diagnosis, assessment, treatment, and clinical management of patients in a public health center...must submit a copy of both my current valid Registered Nurse license AND my Nurse more
    Sacramento County (10/21/25)
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  • Nurse Case Manager I

    International Medical Group (Indianapolis, IN)
    …or tasks as assigned. QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing direct ... creating the best experience for travelers. JOB DETAILS + RN License -- Must have an active RN...assistance cases. + Knowledge of the Non-certification process and Appeals process including logs and time frames. + Participate… more
    International Medical Group (11/16/25)
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  • LTSS Coordinator - Nevada

    System One (Las Vegas, NV)
    …medical criteria and standards of care Licensure and Certification: + Current, unrestricted Registered Nurse ( RN ), Licensed Social Worker (LSW), or Licensed ... monitors and promotes effective utilization of long-term services and supports through clinical review and benefits management. Essential Functions: + Serve as point… more
    System One (12/26/25)
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  • Nurse Practitioner All Specialties…

    City and County of San Francisco (San Francisco, CA)
    …experience. + One (1) year (equivalent to 2,000 hours) of experience as a Registered Nurse on a psychiatric inpatient unit, psychiatric emergency service clinic ... of the multidisciplinary health care team and performs specialized nurse practitioner duties in clinical settings. The...Practitioner (NP) license issued by the California Board of Registered Nursing; AND + LICENSE*: Possession of a current… more
    City and County of San Francisco (12/31/25)
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  • Senior Director Case Management

    Houston Methodist (Houston, TX)
    …leading multi-site or enterprise-level programs preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... and advancement of a unified case management model grounded in clinical excellence, throughput efficiency, care transitions, and denials prevention. A champion… more
    Houston Methodist (10/16/25)
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  • Director, Utilization Management

    Alameda Health System (Oakland, CA)
    …nursing background. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California. Preferred ... of quality improvement initiatives. + Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals .… more
    Alameda Health System (11/07/25)
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  • Utilization Management - Nurse Manager

    Sanford Health (Rapid City, SD)
    …experience preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... these conditions. Additionally includes admission certification, continued stay authorization, clinical documentation improvement, and interaction with payers. Additional duties… more
    Sanford Health (12/17/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... continued stay review. + Communication to third-party payers for initial and concurrent clinical review. + Reviews patient chart to ensure patient continues to meet… more
    University of Utah Health (12/31/25)
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  • Utilization Management Coordinator (H)

    Saint Francis Health System (Tulsa, OK)
    …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), ... notification and performing Nonclinical roles .** Job Summary: Provides administrative and clinical support to the hospital and treatment team throughout the review… more
    Saint Francis Health System (12/31/25)
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