• RN Utilization Review - Case…

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a ... Registered Nurse with us, you'll have the...for case management scope of services including: Utilization Management services supporting medical necessity and… more
    Tenet Healthcare (12/03/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... and Barnstable counties. Our Nutrition Services Team consists of registered and licensed dietitians who provide expert nutritional interventions...and Serve Your Community!** **In your role as a Utilization Review & Denials Management more
    Beth Israel Lahey Health (12/14/25)
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  • Utilization Management

    Katmai (Fort Carson, CO)
    …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
    Katmai (11/26/25)
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  • Behavioral Health Utilization

    AmeriHealth Caritas (LA)
    **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... to 2 weekends per year **Education & Experience** + Registered Nurse candidates: Associate Degree in Nursing...and American Society of Addiction Medicine (ASAM) criterion + Utilization management experience within a managed care… more
    AmeriHealth Caritas (11/19/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in...+ Do you have experience with Utilization Review ? + Do you have an Active Registered more
    US Tech Solutions (10/17/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... . 1+ years of inpatient hospital experience . Registered Nurse in state of residence ....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE… more
    US Tech Solutions (10/17/25)
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  • Care Manager RN - Utilization

    Providence (Polson, MT)
    …upon hire: Montana Registered Nurse License + 1 year experience in care management or utilization review in any setting or + Upon hire successful ... **Description** **Care Manager RN - Utilization Review ...working between 8am-6:30pm Sat/Sun & 8-12pm (Mondays)** The Inpatient Registered Nurse ( RN ) Care Manager… more
    Providence (12/19/25)
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  • SNF Utilization Management RN

    Humana (Jackson, MS)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (12/12/25)
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  • Care Manager RN - Utilization

    Highmark Health (Harrisburg, PA)
    …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience **LICENSES AND… more
    Highmark Health (12/18/25)
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  • Utilization Management Nurse

    Saint Francis Health System (OK)
    …in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the details ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: Minimum 2...nor does it prohibit the assignment of additional duties. Utilization Review Management - Yale… more
    Saint Francis Health System (12/13/25)
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