• Care Manager RN - Utilization

    Highmark Health (Harrisburg, PA)
    …+ Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience **LICENSES AND CERTIFICATIONS** **Required** + Current ... Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
    Highmark Health (12/18/25)
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  • RN Utilization Review

    Sanford Health (Rapid City, SD)
    …patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients ... and standards of nursing practice as outlined in the Nurse Practice Act and Administrative Rules in state of...two years' clinical experience preferred. Currently holds an unencumbered RN license with the State Board of Nursing where… more
    Sanford Health (12/24/25)
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  • Utilization Management Manager, Medicare…

    UCLA Health (Los Angeles, CA)
    …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management, and concurrent review ... all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and… more
    UCLA Health (12/30/25)
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  • Case Manager ( RN ) - Inpatient…

    Stanford Health Care (Palo Alto, CA)
    …affect the processes and outcomes of patient health care **Licenses and Certifications** + CA- RN ( Registered Nurse ) required **These principles apply to ALL ... responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient… more
    Stanford Health Care (11/11/25)
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  • Case Manager PRN

    HCA Healthcare (Gainesville, FL)
    …in Case Management is preferred + BSN is preferred + Certification in Case Management, Nursing or Utilization Review is preferred HCA Florida North ... patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party...personal growth, we encourage you to apply for our Case Manager PRN opening. We promptly review more
    HCA Healthcare (01/07/26)
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  • Nurse Navigator - Transitions of Care

    Hackensack Meridian Health (Edison, NJ)
    …its Quality Metrics. + Knowledge of health care delivery system, utilization and review and case review procedures. + Knowledge of Social Determinants of ... Health needs. The navigator is accountable for a designated case load determined by the careful daily selection of...**Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health… more
    Hackensack Meridian Health (11/14/25)
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  • RN Case Manager Lead

    HCA Healthcare (Derry, NH)
    …and patient throughput while supporting a balance of optimal care and appropriate resource utilization . + The RN Case Manager Team Lead will identify ... colleagues in their positions. Join our Team as a(an) RN Case Manager Lead and access programs...Nursing, Bachelors strongly desired, Master preferred + Active NH Registered Nurse license or compact state … more
    HCA Healthcare (12/05/25)
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  • Manager, Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse more
    Children's Mercy Kansas City (12/15/25)
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  • RN Case Manager PRN

    HCA Healthcare (Denver, CO)
    …of optimal care and appropriate resource utilization . **What qualifications you will need:** + ( RN ) Registered Nurse license + Registered Nurse ... want you to apply! **Job Summary and Qualifications** The Registered Nurse ( RN ) CM is...encourage you to apply for our RN Case Manager PRN opening. We promptly review more
    HCA Healthcare (12/16/25)
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  • Nurse III

    US Tech Solutions (Branchburg, NJ)
    … on an **acute/critical care** unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care ... Schedule - 7:30 am-4:00 pm M-F We need an RN that has at least 5 years' experience in...Tissue/Blood banking * Critical care skill set. The chart review is critical, and the candidate must have knowledge… more
    US Tech Solutions (10/17/25)
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