• Registered Nurse…

    Beth Israel Lahey Health (Boston, MA)
    …people's lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts +… more
    Beth Israel Lahey Health (09/10/25)
    - Related Jobs

  • Utilization Review Specialist…

    Rochester Regional Health (Rochester, NY)
    Job Title: Utilization Review Specialist ( RN ) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours ... Review Specialist actively participates in the utilization management of patients and evaluating hospital...Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (10/07/25)
    - Related Jobs

  • Regional Utilization Review…

    Trinity Health (Maywood, IL)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer - Regional Coverage for Loyola, Gottlieb and MacNeal ... Hospitals. Utilization Review - RN Reviewer..., typing and communication skills are necessary. + Current Registered Nurse License State of Illinois +… more
    Trinity Health (10/01/25)
    - Related Jobs

  • Utilization Review Registered…

    Centene Corporation (New York, NY)
    …NY RN Licensure as well as a State Issued NY ID.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all ... 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 (10/15/25)
    - Related Jobs

  • Staff Nurse - Utilization…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management...skill set *_QUALIFICATIONS:_* /*Minimum Qualifications:*/ * 1 year of recent* utilization review , utilization management… more
    Minnesota Visiting Nurse Agency (10/02/25)
    - Related Jobs

  • Clinical Utilization Review…

    Community Health Systems (Franklin, TN)
    …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... Nursing preferred + 2-4 years of clinical experience in utilization review , case management , or...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
    Community Health Systems (10/14/25)
    - Related Jobs

  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …the appropriate utilization of resources, coordination of payer communication, and utilization review and management . Responsible for carrying out duties ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional...in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National… more
    Minnesota Visiting Nurse Agency (09/30/25)
    - Related Jobs

  • Behavioral Health Utilization Review…

    Actalent (Fort Lauderdale, FL)
    Actalent is Hiring a Behavioral Health Utilization Review Nurse Job Description We are seeking a dedicated Utilization Management Nurse (UMN) who ... Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (10/15/25)
    - Related Jobs

  • Behavioral Health Utilization Review…

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... health. + Proficiency in clinical and utilization review processes. + Current unrestricted Florida RN ...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (10/10/25)
    - Related Jobs

  • Utilization Review and Nurse…

    Idaho Division of Human Resources (Nampa, ID)
    Utilization Review and Nurse Educator - SHW Posting Begin Date: 2025/09/22 Posting End Date: 2025/10/20 Category: Nursing Work Type: Full Time Location: ... Seniorto take on a critical role in our Utilization Review , Performance Improvement, Nursing Education programs....for this position. + Licensed as a Professional or Registered Nurse in Idaho as defined by… more
    Idaho Division of Human Resources (09/23/25)
    - Related Jobs