• Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …and well-being of the unique communities we serve. Summary: This position facilitates utilization management processes to support the right care is provided at ... EXPERIENCE REQUIREMENT Five (5) years of health care experience as a Registered Nurse . LICENSURE/REGISTRATION/CERTIFICATION Licensed to practice as a … more
    UNC Health Care (12/17/25)
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  • Nurse Case Manager - FT Days

    Nuvance Health (Poughkeepsie, NY)
    …BSN preferred. Must have current RN license. *Preferred Experience: * Utilization Review / Management .Company: Vassar Brothers Medical Center Org Unit: ... case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within… more
    Nuvance Health (09/28/25)
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  • Nurse Manager Patient Throughput

    HCA Healthcare (Kissimmee, FL)
    …monitor and improve the patient flow program effectiveness as it relates to utilization review , resource management , and discharge planning and care ... leader to physicians and employees as it relates to utilization review , resource management , patient...obtained within 30 days of employment start date + ( RN ) Registered Nurse + Associate… more
    HCA Healthcare (12/11/25)
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  • Executive System Director of Utilization

    UNC Health Care (Morrisville, NC)
    …the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and operational leader responsible ... for designing, implementing, and standardizing utilization management functions across a large healthcare...Operational oversight of centralized and site-specific UM teams, including utilization review nurses and support staff. Cultivate… more
    UNC Health Care (10/29/25)
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  • Utilization Management Manager

    State of Indiana (Indianapolis, IN)
    …The role of Utilization Management Manager oversees the integration of utilization review , clinically appropriate care and risk management for the ... Utilization Management Manager Date Posted: Nov...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
    State of Indiana (11/20/25)
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  • RN - Case Manager - Full Time - Days - 4…

    Mohawk Valley Health System (Utica, NY)
    …regulatory compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work ... RN - Case Manager - Full Time -...Reports to and is under direct supervision of Case Management Department. Provides ongoing support and expertise through comprehensive… more
    Mohawk Valley Health System (11/15/25)
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  • RN Case Manager

    Cleveland Clinic (Medina, OH)
    …build a rewarding, lifelong career while receiving endless support and encouragement. As a Registered Nurse ( RN ) Case Manager, you will work collaboratively ... of professional nursing + Current state licensure as a Registered Nurse ( RN ) + Basic...or CCM) + Two years of recent experience in utilization review , quality or care management more
    Cleveland Clinic (12/19/25)
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  • Utilization Review Nurse I

    Centene Corporation (New York, NY)
    …clinical license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
    Centene Corporation (12/05/25)
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  • Utilization Management Specialist II

    AnMed Health (Anderson, SC)
    …, continued stay/concurrent review , retrospective review , bed status management , resource utilization management , regulatory compliance, and related ... issues. Duties & Responsibilities + Performs assigned utilization management functions daily: initial, concurrent and retrospective review of the… more
    AnMed Health (11/13/25)
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  • Clinical Product Consultant - Utilization

    Waystar (Atlanta, GA)
    …end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of...Bachelor of Science in Nursing (BSN) or equivalent (with RN licensure) + 8+ years of clinical experience in… more
    Waystar (11/21/25)
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