• RN Care Manager- Clinical Resource…

    Kadlec (Richland, WA)
    …recent inpatient clinical experience in an acute care facility. + Previous Case Management , discharge planning or utilization review experience. **Why Join ... care. Has the overall accountability for the integrated responsibilities of case management ; utilization management , discharge planning, facilitation and… more
    Kadlec (09/23/25)
    - Related Jobs
  • Clinical Reviewer

    Independent Health (Buffalo, NY)
    …with regulatory standards, clinical criteria, and member benefit contract. **Qualifications** + Registered Nurse ( RN ) with active, current, unrestricted NYS ... credentials preferred. + Four (4) years of clinical experience required. Utilization Management experience preferred. + Comprehensive knowledge and experience… more
    Independent Health (10/07/25)
    - Related Jobs
  • 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)
    - Related Jobs
  • Inpatient Utilization Review

    Emory Healthcare/Emory University (Atlanta, GA)
    …and leadership programs + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting ... physician and/or physician advisor. This individual will: + Perform utilization review by completing a timely and...patient and hospital financial risk. + Initiate and facilitate RN to RN discussion and/or Physician to… more
    Emory Healthcare/Emory University (10/20/25)
    - Related Jobs
  • Case Manager, Registered Nurse

    Sutter Health (San Francisco, CA)
    …in nursing, case management or related field. **CERTIFICATION & LICENSURE** + RN - Registered Nurse of California (required) + CCM-Certified Case Manager ... Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The … more
    Sutter Health (08/16/25)
    - Related Jobs
  • Registered Nurse Case Manager PRN

    HCA Healthcare (Mcallen, TX)
    …to physicians, patients, families and caregivers **What qualifications you will need:** + ( RN ) Registered Nurse + Bachelors Degree Preferred, or Associate ... case management scope of services including + Utilization Management supporting medical necessity and denial...encourage you to apply for our Registered Nurse Case Manager PRN opening. We review more
    HCA Healthcare (10/15/25)
    - Related Jobs
  • Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …to physicians, patients, families and caregivers **What qualifications you will need:** + ( RN ) Registered Nurse + Bachelors Degree, or Associate Degree ... case management scope of services including + Utilization Management supporting medical necessity and denial...encourage you to apply for our Registered Nurse Case Manager opening. We promptly review more
    HCA Healthcare (10/13/25)
    - Related Jobs
  • Registered Nurse Case Manager…

    Northwell Health (Staten Island, NY)
    **Req Number** 167724 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
    Northwell Health (09/17/25)
    - Related Jobs
  • Registered Nurse Care Manager PRN

    AdventHealth (Palm Coast, FL)
    …and experiences you'll need to succeed:** **Minimum qualifications** : + Associate's degree Nursing or RN Diploma degree. + Registered Nurse ( RN ) State ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...+ Health-related Master's degree or MSN. + Prior Care Management / Utilization Management experience. + ACM/CCM… more
    AdventHealth (08/27/25)
    - Related Jobs
  • Case Manager, Registered Nurse

    CVS Health (Phoenix, AZ)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (10/15/25)
    - Related Jobs