- Fresenius Medical Care (Fayetteville, NC)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Christus Health (Somerset, TX)
- …on for more details, and make sure to apply today. The nurse manager affects departmental outcomes through interpretation, implementation, and evaluation of hospital ... excellence in patient care, patient experience and patient outcomes. Effectively manages utilization of staff and material resources so that the most therapeutically… more
- Interim HealthCare (Greenwood, IN)
- …(RNCM) with us, you will need: Licensure: Current unrestricted license to practice as a Registered Nurse ( RN ) in the state associated with this position ... One (1) year of professional experience practicing as a Registered Nurse ( RN ) in home...) in home health or similar setting; previous case management / utilization review experience preferred. OASIS experience preferred.… more
- CenterWell Home Health (Pittsfield, MA)
- …driver's license, auto insurance and reliable transportation. Two years as a Registered Nurse with at least one-year of management experience in a home care, ... sit on-site at our Pittsfield, MA branch location. The RN Clinical Manager coordinates and oversees all direct care...accredited School of Nursing. Current state license as a Registered Nurse . Proof of current CPR. Valid… more
- Kaiser Permanente (Clackamas, OR)
- …the telephone as in person. Basic Qualifications: Experience Three (3) years of Registered Nurse experience, one year in clinical specialty. Education High ... GED. Graduate of accredited school of nursing. License, Certification, Registration Registered Nurse License (Oregon). Basic Life Support. Additional… more
- University Health (San Antonio, TX)
- …Experience in an HMO setting or managed care is required. LICENSURE/ CERTIFICATIONS If a Registered Nurse or Social Worker must be licensed in the State of ... POSITION SUMMARY/RESPONSIBILITIES Provide oversight and management of the Community First Health Plans (CFHP)...STAR Kids clinical and administrative staff. Oversee the efficient utilization of resources within the schedule of benefits for… more
- CVS Health (Austin, TX)
- …the department.** **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical ... with diverse cultural dynamics of clinical staff and patients. Registered Nurse ( RN ) required. Licensed...(LCSW) preferred. + Requisition Job Description **Position Summary** This Utilization Management (UM) Nurse Consultant… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Cottingham &...20260112 Featured Job TH Ad TH Comments **Similar Jobs** RN - Float Pool Registered Nurse ... 4627707008 Posted On 07/01/2025 Refreshed On 11/23/2025 **Job Overview** ** Utilization Management Nurse ** **Location** :... RN - Birth Center Registered Nurse MercyOne Cardiac Care Nurse Medical Associates… more
- 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 ... coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and nationally...* Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state… more
