• Behavioral Health Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... of services and care. * Provides referrals to Case management , Disease Management , Appeals & Grievances, and...* Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state… more
    Brighton Health Plan Solutions, LLC (11/22/25)
    - Related Jobs
  • Utilization Management Nurse

    Brighton Health Plan Solutions, LLC (NC)
    …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... of services and care. * Provides referrals to Case management , Disease Management , Appeals & Grievances, and...requirements. * Duties as assigned. Essential Qualifications * Current Registered Nurse ( RN ) with state… more
    Brighton Health Plan Solutions, LLC (10/11/25)
    - Related Jobs
  • Nurse Manager - Patient Access Center…

    Veterans Affairs, Veterans Health Administration (Seattle, WA)
    … professional nurse who exemplifies leadership and oversees registered nurse ( RN ) and advanced medical support assistant (AMSA) staff within ... Washington. The Nurse Manager directly supervises the RN Utilization Management /Discharge Planners, AMSA Discharge Coordinators,...RNs, and Traveling Veteran Coordinators. Responsibilities The Nurse Manager (NM) is a registered more
    Veterans Affairs, Veterans Health Administration (11/16/25)
    - Related Jobs
  • Home Health Professional Staff Nurse - Cole

    UPMC (Coudersport, PA)
    …+ Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) OR Temporary Practice Permit (TPP) + Act ... UPMC Home Health is hiring a Registered Nurse for the area. Are...of care in collaboration with physicians, patients, and utilization management ( UM ) professionals to meet physicians' orders… more
    UPMC (09/13/25)
    - Related Jobs
  • Patient Care Technician (Part-time) - PAV 5,…

    University of Michigan (Ann Arbor, MI)
    …directly relate to this position. **Job Summary** Under direct supervision from a Registered Nurse or other designated supervision, provide direct patient care ... patient care and related duties. **Desired Qualifications + Completion of a Certified Nurse Aide or Certified Medical Assistant program + Basic computer skills… more
    University of Michigan (11/18/25)
    - Related Jobs
  • Nursing Supervisor (University Hospital, Adult…

    University of Michigan (Ann Arbor, MI)
    …ACLS certification + Current TNCC certification + Critical Care Registered Nurse Certification + Experience working with Electronic Medical Record. + ... Masters degree in Nursing + Current licensure as a Registered Nurse in the State of Michigan....RN experience in an Adult Emergency Department. + Nurse Leadership certification or completion of a nursing leadership… more
    University of Michigan (11/15/25)
    - Related Jobs
  • Staff Nurse - Utilization Review (ED)

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the medical necessity, ... RN conducts timely reviews of inpatient and outpatient medical records to determine the appropriateness of admissions, continued.../*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of… more
    Minnesota Visiting Nurse Agency (10/02/25)
    - Related Jobs
  • Care Review Clinician - NM resident - Licensed LPN…

    Molina Healthcare (NM)
    …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse (LVN)… more
    Molina Healthcare (10/30/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team. In ... (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We...computer. + Flexibility to provide coverage for other Utilization Management ( UM ) Nurses across various UM more
    CVS Health (10/31/25)
    - Related Jobs
  • Nurse

    Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
    …and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a Nurse ... of revenue reimbursement processes and under moderate supervision and instruction by the registered nurse manager. Responsibilities of the RUR nurse include,… more
    Veterans Affairs, Veterans Health Administration (11/16/25)
    - Related Jobs