• VP Care Management Post-Acute Care…

    Kaleida Health (Buffalo, NY)
    …preferred. RN licensure required.** **Experience** **10 years of care management / utilization management experience required in hospital and/or ambulatory ... **VP Care Management Post-Acute Care Transition** **Location:** **Buffalo General Medical...daily oversight of operations, the VP will partner with Utilization Review , Revenue Cycle, and Clinical leadership… more
    Kaleida Health (09/17/25)
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  • Registered Nurse RN - Case…

    Trinity Health (Ann Arbor, MI)
    …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
    Trinity Health (10/18/25)
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  • RN Auditor, Clinical Services remote based…

    Molina Healthcare (Bellevue, WA)
    … licensure required **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ... Clinical Services Auditor performs auditing of clinical staff in Utilization Management (UM), Case Management ...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
    Molina Healthcare (10/18/25)
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  • Registered Nurse ( RN )DC-…

    Health Advocates Network (Selinsgrove, PA)
    Registered Nurse ( RN )DC- Short-Term **Pay Rate:** $63 / hour *W2 Minimum Qualifications Possession of a current license to practice as a registered ... nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse...is reviewed and evaluated by a Registered Nurse Supervisor, physician or dentist through observation, review more
    Health Advocates Network (09/16/25)
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  • Prior Authorization, RN - Hybrid Remote

    Fallon Health (Worcester, MA)
    Nurse in a clinical setting required. + 2 years' experience as a Utilization Management /Prior Authorization nurse in a managed care payer preferred. + ... in nursing required** **License/Certifications** + Active and unrestricted licensure as a Registered Nurse in Massachusetts. **Experience** + A minimum of three… more
    Fallon Health (10/02/25)
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  • Clinical Reviewer , Nurse -9am -6pm…

    Evolent (Oklahoma City, OK)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on… more
    Evolent (10/21/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (West Valley City, UT)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (10/18/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Las Vegas, NV)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (10/18/25)
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  • Registered Nurse ( RN ) Care…

    Whitney Young Health Center (Albany, NY)
    Registered Nurse ( RN ) Care Manager (Req 100984) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description Be a part of ... principles of Patient Centered Medical Home (PCMH), the Care Manager ( RN ) will demonstrate professional nursing practice, excellent communication and critical… more
    Whitney Young Health Center (08/16/25)
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  • Hospice Registered Nurse RN

    Aveanna Healthcare (Greenville, AL)
    Hospice Registered Nurse RN Part Time ApplyRefer a FriendBack Job Details Requisition #: 207171 Location: Greenville, AL 36037 Category: Nursing Salary: ... care and patient needs. + Participates in quality improvement, utilization review , and infection control activities as...takes corrective action. Qualifications: + Current license as a Registered Nurse in the State of Alabama… more
    Aveanna Healthcare (10/07/25)
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