• Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    …you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination in a behavioral health or substance use treatment ... compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals,… more
    BriteLife Recovery (10/04/25)
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  • Clinical Manager, Behavioral Health (UM)…

    Magellan Health Services (Boise, ID)
    …Professional Counselor - Care MgmtCare Mgmt, PC - Professional Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - ... , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management ...required: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC or RN . If RN , BSN preferred but ASN… more
    Magellan Health Services (10/17/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... medical necessity, admission status, level of care, and resource management . The RN CM Care Coordinator will...required within 90 days of hire + Advanced Practice Registered Nurse license is acceptable for position… more
    HCA Healthcare (10/18/25)
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  • RN Case Manager

    HCA Healthcare (Orange Park, FL)
    **Description** **Introduction** Do you have the career opportunities as a Weekend ** Registered Nurse ( RN ) Case Manager** you want with your current ... expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case Manager...Management is highly preferred. + Certification in Case Management or Utilization Review is preferred. +… more
    HCA Healthcare (10/01/25)
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  • RN Case Manager Lead

    HCA Healthcare (Wichita, KS)
    …initiatives **Qualifications:** **Required:** + Current Licensure in the State of Kansas as a Registered Nurse ( RN ) or Current Multi-State Licensure as a ... management regulatory guidelines per CMS. + Manages VPro utilization for case management vendors + Assists...Registered Nurse ( RN ) + Current Basic Life Support… more
    HCA Healthcare (10/10/25)
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  • RN Case Manager

    HCA Healthcare (Tallahassee, FL)
    …assess observation patients for appropriateness in observation status** + **Performs utilization management reviews and communicates information to third party ... medical necessity, admission status, level of care, and resource management . The RN CM Care Coordinator will...required within 90 days of hire** + **Advanced Practice Registered Nurse license is acceptable for position… more
    HCA Healthcare (09/21/25)
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  • RN Case Manager PRN

    HCA Healthcare (Kissimmee, FL)
    …patient safety.​ + ​Other duties as assigned.​ **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree + Bachelor's in Nursing ... status issues through established chain of command.​ + ​Performs utilization management reviews and communicates to third...+ 1+ year of prior case management experience + Registered Nurse … more
    HCA Healthcare (08/28/25)
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  • RN Case Manager - Inpatient Case…

    Cambridge Health Alliance (Somerville, MA)
    …Campus **Work Days:** Mon-Fri; 8:00-4:30, rotating weekends and holidays **Category:** Registered Nurse **Department:** Inpatient Case Management SH ... RN Case Manager - Inpatient Case Management...Somerville **This position in onsite in Somerville** Department Description: Utilization review (UR) in behavioral health that… more
    Cambridge Health Alliance (10/04/25)
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  • RN Case Manager

    HCA Healthcare (Jacksonville, FL)
    …at **HCA Florida Memorial Hospital** have the opportunity to make a real impact. As a ** Registered Nurse ( RN ) Case Manager** you can be a part of change. ... expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case Manager...Management is highly preferred. + Certification in Case Management or Utilization Review is preferred. +… more
    HCA Healthcare (10/10/25)
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  • RN Case Manager

    HCA Healthcare (Orange Park, FL)
    …our nurses set us apart from any other healthcare provider. We are seeking a ** Registered Nurse ( RN ) Case Manager** to join our healthcare family. ... opportunity. **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case Manager...Management is highly preferred. + Certification in Case Management or Utilization Review is preferred. +… more
    HCA Healthcare (10/02/25)
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