• RN Clinical Manager, Home Health

    CenterWell (Madison, FL)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (12/10/25)
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  • Utilization Management Nurse

    Actalent (Minnetonka, MN)
    …to assess the medical necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review . + Experience in acute ... Utilization Management Nurse Job Description As...inpatient rehabilitation, and long-term acute care hospitals. Responsibilities + Review and document prior authorization and concurrent stay requests.… more
    Actalent (12/09/25)
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  • Utilization Management Nurse

    CenterWell (San Juan, PR)
    …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
    CenterWell (11/22/25)
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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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  • Clinical Supervisor RN

    Children's Home Healthcare (Albuquerque, NM)
    …for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional Services. ... NOT APPLY IF YOU DO NOT HAVE A VALID RN LICENSE* Children's Home Healthcare is now...CPR + At least 2 years experience as a Registered Nurse + At least 1 year… more
    Children's Home Healthcare (12/03/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
    CenterWell (11/13/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Orem, UT)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (12/01/25)
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  • RN Care Mgr II

    Covenant Health Inc. (Lenoir City, TN)
    Overview Registered Nurse Care Manager, Quality Management PRN/OCC,Hours and Shifts Vary Fort Loudoun Medical Center Overview: Fort Loudoun Medical Center is ... care to every patient, every time. Position Summary: The RN Care Manager II is responsible for integrating evidenced...management services within the scope of practice as a registered nurse meeting all required standards both… more
    Covenant Health Inc. (12/04/25)
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  • RN Case Manager PRN

    HCA Healthcare (Kissimmee, FL)
    …patient safety.​ + ​Other duties as assigned.​ **What qualifications you will need:** + ( RN ) Registered Nurse + Associate Degree + Bachelor's in Nursing ... + 1+ year of prior case management experience + Registered Nurse - Currently licensed as a...opportunity compelling, we encourage you to apply for our RN Case Manager PRN opening. We promptly review more
    HCA Healthcare (11/10/25)
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  • RN Case Manager PRN

    HCA Healthcare (Orange Park, FL)
    **Description** **Introduction** Do you have the PRN career opportunities as a ** Registered Nurse ( RN ) Case Manager** you want with your current employer? We ... expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse ( RN ) Case Manager...this PRN position. + Certification in Case Management or Utilization Review is preferred. + InterQual experience… more
    HCA Healthcare (12/03/25)
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