• Staff Nurse - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... performance review /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of Minnesota. **Title:** *Staff … more
    Minnesota Visiting Nurse Agency (10/02/25)
    - Related Jobs
  • Utilization Management Reviewer, RN

    Excellus BlueCross BlueShield (Rochester, NY)
    …improving member and community health. + Manages more complex assignments; cross-trained to review various levels of care and/or services. + Participate in ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
    Excellus BlueCross BlueShield (10/07/25)
    - Related Jobs
  • RN - Clinical Coord

    UnityPoint Health (Cedar Rapids, IA)
    …+ Identifies needed interventions, and communicates and collaborates with physician and primary nurse to individualize plan of care to meet patient's needs. + ... Patient Care Coordinator role is designed predominantly for an RN , although candidates with commiserate healthcare experience may be considered. Baccalaureate… more
    UnityPoint Health (11/19/25)
    - Related Jobs
  • RN Supervisor for Emergency Observation…

    Trinity Health (Troy, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Nurse Supervisor for NEW ED Observation Unit at Samaritan Hospital** **Pavilion Building - ... 4T** **EXEMPT** **FT Days** If you are an experienced RN looking for a **_leadership_** position in the Observation/Clinical...your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. **Position Highlights:**… more
    Trinity Health (11/14/25)
    - Related Jobs
  • Executive System Director of Utilization…

    UNC Health Care (Morrisville, NC)
    …program. 2. **Leading People** - Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. ... serve. **Summary** : The **Executive System Director of Utilization Management ( UM )** is a strategic and operational leader responsible for designing, implementing,… more
    UNC Health Care (10/29/25)
    - Related Jobs
  • Medical Utilization Review Nurse

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …as assigned. Essential Qualifications * Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state licensure. Must retain active and ... Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review ...URAC and NCQA. * 2+ years' experience in a UM team within managed care setting. *… more
    Brighton Health Plan Solutions, LLC (11/22/25)
    - Related Jobs
  • Utilization Review Case Mgr - CMC - Clear…

    UTMB Health (Webster, TX)
    …testing is also required. **_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of three (3) years ... with complicated treatment plans through multidisciplinary conferences and medical record review . + Facilitates clinical care progression of patient throughout… more
    UTMB Health (11/21/25)
    - Related Jobs
  • Utilization Review Nurse - Remote

    Martin's Point Health Care (Portland, ME)
    …in a health plan UM department Required License(s) and/or Certification(s): + Compact RN License + Certification in managed care nursing or care ... been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt of high… more
    Martin's Point Health Care (11/15/25)
    - Related Jobs
  • Care Review Clinician (BH Licensed)

    Molina Healthcare (Louisville, KY)
    …for state of KY or RN who must be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior ... to other clinical programs. * Collaborates with multidisciplinary teams to promote Molina care model. * Adheres to utilization management ( UM ) policies and… more
    Molina Healthcare (11/09/25)
    - Related Jobs
  • Patient Care Technician

    University of Michigan (Ann Arbor, MI)
    Care Technician Apply Now **Job Summary** Under direct supervision from a Registered Nurse or other designated supervision, provides direct patient care ... with admissions, discharges, and transfers. + Provide skin care at the direction of the RN ,...or equivalent **Desired Qualifications + Completion of a Certified Nurse Aide or Certified Medical Assistant program; basic computer… more
    University of Michigan (11/22/25)
    - Related Jobs