• Outcomes Manager , MSW, LSW, Part Time

    Virtua Health (Mount Holly, NC)
    …and/or certification from the State of New Jersey as a MSW or Registered Nurse . Case Management Certification (requirement within one year of ... RN or Masters prepared Licensed Social Worker.Preferred: 3 years clinical nursing ( RN ) experience and 1 year UR /CM/QM experience or 3 years experience as… more
    Virtua Health (12/03/25)
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  • Outpatient Care Manager

    Stony Brook University (Stony Brook, NY)
    …in Care Management + Experience in Managed Care/Insurance Industry/MD Office. + Certified in Case Management, UR , Quality or Risk + PRI Certified + Experience in ... Outpatient Care Manager **Position Summary** At Stony Brook Medicine, a...projects or other duties as assigned. **Qualifications** **Required:** + RN Licensure in NY State + Outpatient community service… more
    Stony Brook University (11/20/25)
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  • Supv Regional Care Mgmt- Integrated Care Mgmt…

    Sharp HealthCare (San Diego, CA)
    …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... + 2 Years Medical Management experience, preferably in a managed care setting + California Registered Nurse ( RN ) - CA Board of Registered Nursing… more
    Sharp HealthCare (10/07/25)
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  • Utilization Management Specialist

    Cleveland Clinic (Cleveland, OH)
    …of admission and continued stays. + Maintain and support collaborative relationships with RN Case Manager , Physicians and the multidisciplinary team. + ... appropriately in UM notes to provide evidence that the UR process for the case was followed....School of Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic… more
    Cleveland Clinic (10/18/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …members or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity ... utilization to identify at risk patients. + Refers to UR committee any case that surpasses expected...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… more
    University of Utah Health (10/02/25)
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  • Utilization Management Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... Manager appropriate information including, but not limited to, customer/ case issues, reports, trends/variances, action plans, etc. **SUPERVISORY RESPONSIBILITY:**… more
    CareFirst (11/22/25)
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  • Utilization Management Coordinator

    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), or ... internal processes. Provides staff education as needed to further the goals of UR . Minimum Education: Has completed the basic professional curricula of a school of… more
    Saint Francis Health System (11/14/25)
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  • Care Coord

    UnityPoint Health (Des Moines, IA)
    …of clinical experience in focused areas working with multidisciplinary teams License(s)/Certification(s): + Current RN Licens ur e in state of Iowa Other: + Dept ... evaluation of patient-focused care for prioritized patients . + Documents the case management plan to include: clinical needs, barriers to quality care, effective… more
    UnityPoint Health (10/17/25)
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