• Utilization Reviewer ( RN )- Full…

    Atlantic Health System (Morristown, NJ)
    …Assists in identification and collection of avoidable days 7. Coordinates with the CM RN and/or CMA to identify and complete the process for CMS required patient ... notices. 8. Completes and documents utilization reviews, physician advisor referrals and other communications related...school of nursing - required BSN - preferred Current RN license - required Case Management - Preferred At… more
    Atlantic Health System (01/14/26)
    - Related Jobs

  • RN - Case Manager - BSN -…

    John Muir Health (Walnut Creek, CA)
    …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + ... case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the...this in coordination with the interdisciplinary health team. The RN Case Manager is expected to function within the… more
    John Muir Health (12/27/25)
    - Related Jobs

  • Utilization Review RN

    Actalent (Atlanta, GA)
    Urgent Hiring for "UM RN " in Atlanta ,GA Must be Located closer to Atlanta, GA Job Description: + Review and approve precertification and medical necessity for ... (claims, benefits, appeals, risk management). Required Qualifications + Active RN license in Georgia or Compact State. + BSN...+ BSN degree required. + Minimum 1 year of utilization review experience. + Minimum 1 year of managed… more
    Actalent (01/11/26)
    - Related Jobs

  • RN Utilization Review Specialist…

    Amergis (Dover, DE)
    The Utilization Review Specialist is responsible for theassessment and review of the healthcare delivery system with a concentration ontasks that promote ... + Current license for the state in which the nurse practicesif nursing licensure is required by contract +...Degree in Nursing or at least two years'experience in Utilization Review preferred + Certification in Utilization … more
    Amergis (01/14/26)
    - Related Jobs

  • RN Utilization Review/Discharge…

    Sanford Health (Rapid City, SD)
    …patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients ... and standards of nursing practice as outlined in the Nurse Practice Act and Administrative Rules in state of...two years' clinical experience preferred. Currently holds an unencumbered RN license with the State Board of Nursing where… more
    Sanford Health (12/24/25)
    - Related Jobs

  • Staff Nurse - Utilization Review…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... annual 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 (12/03/25)
    - Related Jobs

  • Manager, Utilization Management

    Centene Corporation (New York, NY)
    …Licensure. Hours are M-F 8:30 am - 5:00 pm with holiday rotation.** **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... benefits including a fresh perspective on workplace flexibility. **Applicants must possess NY RN State Licensure. Hours are M-F 8:30 am - 5:00 pm with holiday… more
    Centene Corporation (01/10/26)
    - Related Jobs

  • Utilization Management Nurse…

    CVS Health (Austin, TX)
    …in clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed Clinical Social Worker (LCSW) ... preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in… more
    CVS Health (01/01/26)
    - Related Jobs

  • Centralized Utilization Review Manager

    Houston Methodist (Katy, TX)
    …performance that demonstrates progressive leadership abilities **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure ... At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading...or CMGT-BC-ANCC or COHN-ABOHN or COHN/CM-ABOHN or CPHRM-AHA-CC or RN -BC-ANCC **SKILLS AND ABILITIES** + Demonstrates the skills and… more
    Houston Methodist (01/14/26)
    - Related Jobs

  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …AED) Programs. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...in a state other than California must provide their Registered Nurse License Number from that state… more
    The County of Los Angeles (12/27/25)
    - Related Jobs