• Quality Management Nurse Consultant

    US Tech Solutions (RI)
    …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... **Job Description:** + Responsible for the review and evaluation of clinical information and documentation....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
    US Tech Solutions (10/17/25)
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  • Case Manager, RN - Case Management

    Northwell Health (Staten Island, NY)
    …care according to regulatory standards. + * Performs concurrent utilization management using Interqual criteria. + Conducts chart review for appropriateness ... license to practice as a Registered Professional Nurse in New York State. + Case Management... and clinical pathways, variance analysis and trending, quality management / utilization review and home care/discharge… more
    Northwell Health (12/20/25)
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  • Manager of Utilization Management I

    Elevance Health (Tampa, FL)
    …practitioners responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure cost effective ... reside in the state of Florida* The **Manager of Utilization Management ** is responsible for managing a...would provide an equivalent background. + Current active unrestricted RN , PA, LSW, LCSW, LPC, LMHC or other accepted… more
    Elevance Health (12/11/25)
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  • Registered Nurse Utilization

    Catholic Health (Kenmore, NY)
    …Days with Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse ( RN ), Utilization Review , as an active member of the Middle ... in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with...facilitate movement of the patient through the continuum. The Utilization Review RN identifies and… more
    Catholic Health (12/17/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Sayre, PA)
    …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...degree in addition to a degree in Nursing. A registered nurse with five (5) years relevant… more
    Guthrie (12/05/25)
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  • Registered Nurse

    US Tech Solutions (LA)
    …+ Minimum 3 years nursing experience with a minimum of 1 year in utilization management / prior authorization review experience. **Experience** : ... as indicated by staffing and business needs. **Duties:** + ** Registered Nurse with current license in LA...Utilization Management . Prior Authorization Review experience **About US Tech Solutions:** US Tech Solutions… more
    US Tech Solutions (10/17/25)
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  • Registered Nurse Ambulatory Care…

    Intermountain Health (Salt Lake City, UT)
    …Education + Communication + Prioritization **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of ... **Job Description:** The RN Ambulatory Care Manager I delivers comprehensive ambulatory... Management Certification + Demonstrated experience in case management , utilization review , or discharge… more
    Intermountain Health (12/18/25)
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  • RN Care Manager - Care Management

    UNC Health Care (Smithfield, NC)
    …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager ... of employment date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North Carolina. **Professional… more
    UNC Health Care (12/23/25)
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  • Registered Nurse Utilization

    McLaren Health Care (Port Huron, MI)
    …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm...Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure… more
    McLaren Health Care (11/12/25)
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  • Clinical Registered Nurse

    Cognizant (Salem, OR)
    …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
    Cognizant (12/23/25)
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