• Utilization Management Clinician…

    CVS Health (Harrisburg, PA)
    …behavioral health clinical experience in a hospital setting required for either BH or RN -1+ years of utilization review / utilization management required ... they work (LMSW, LCSW, LISW, LPC, LMFT etc.) or Registered Nurse in state of residence -3+...(ie concurrent review , pre-certifications) for BH or RN **Preferred Qualifications** -Experience working with geriatric population and… more
    CVS Health (12/11/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Harrisburg, PA)
    …Health Professional (LMHP) required or + Board Certified Behavior Analyst (BCBA) required + RN - Registered Nurse - State Licensure and/or Compact State ... Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with...Licensure RN - Registered Nurse - State Licensure and/or Compact State… more
    Centene Corporation (12/05/25)
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  • Utilization Review Team Lead

    BayCare Health System (St. Petersburg, FL)
    … Management or 6 years of clinical nursing **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... trust, dignity, respect, responsibility and clinical excellence. **The Team Lead Utilization Review responsibilities include:** + Directing and coordinating the… more
    BayCare Health System (11/12/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
    Albany Medical Center (12/03/25)
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  • Medicaid Utilization Analyst 12 - HSA…

    State of Michigan (Lansing, MI)
    …requirement. Medicaid Utilization Analyst 12 Two years of experience as a Registered Nurse P11 or equivalent may be substituted for the education ... To identify psychotropic medication regimens that require additional physician review according to policy, the Utilization Reviewer...OR at least two years of experience as a Registered Nurse P11 or equivalent. If so,… more
    State of Michigan (12/14/25)
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  • Behavioral Health Care Coordinator - ABA, BCBA,…

    Health Care Service Corporation (Albuquerque, NM)
    …appropriate for treatment within the Autism Spectrum Diagnoses (ASD). **JOB REQUIREMENTS:** ** Registered Nurse ( RN ) or Masters-level Behavioral Health ... decision making skills.** **PC and database experience.** **PREFERRED JOB REQUIREMENTS:** ** Utilization review experience.** **3 years clinical experience in… more
    Health Care Service Corporation (12/03/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Shelby, NC)
    …reliable transportation. + A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home health experience is strongly preferred. + Management ... of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN more
    CenterWell (12/05/25)
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  • RN Weekend Clinical Manager, Home

    CenterWell (Atlanta, GA)
    …**Required Experience/Skills:** + A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home health experience is required. + Management and ... of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN more
    CenterWell (11/21/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Washington, DC)
    …(BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department (ED), ... reviews within a managed care organization preferred **Licensure** + Active and unencumbered Registered Nurse license in the District of Columbia + Valid and… more
    AmeriHealth Caritas (11/20/25)
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  • RN Supervisor A

    Louisiana Department of State Civil Service (Jackson, LA)
    …that honors service through care. Minimum Qualifications Possession of a current Louisiana Registered Nurse license or a temporary permit or multi-state license ... issued by a Nursing Licensure Compact (NLC/eNLC) state to practice as a registered nurse plus one of the following: Three years of experience as a licensed … more
    Louisiana Department of State Civil Service (12/05/25)
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