• Care Manager PreService & Retrospective - Autism

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, LPCC, ... The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness...* 3 years of related, progressive clinical experience (ie RN or LPN to RN mix). *… more
    Blue Cross and Blue Shield of Minnesota (12/18/25)
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  • Nurse Practitioner- Pediatric Hub…

    The County of Los Angeles (Los Angeles, CA)
    …calendar days from application submission. LICENSE(S) REQUIRED: + A license to practice as a Registered Nurse and a certificate to practice as a Nurse ... Do you have a license to practice as a Registered Nurse issued by the California Board...to perform as based on core competencies for the nurse practitioner disciplines. Review and consider your… more
    The County of Los Angeles (12/03/25)
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  • Assistant Nursing Director, Administration

    The County of Los Angeles (Los Angeles, CA)
    …clinical nursing. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered ... in a state other than California must provide their Registered Nurse License Number from that state...Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL… more
    The County of Los Angeles (10/18/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    …responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is ... delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare… more
    Brockton Hospital (12/12/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management… more
    Houston Methodist (10/29/25)
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  • Lead Advanced Practice Provider - Outpatient…

    Stanford Health Care (Palo Alto, CA)
    …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or ... and adherence to policy through practice analysis and case review of APPs with physicians. + Investigate and respond...practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse more
    Stanford Health Care (11/16/25)
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  • Case Manager - PRN

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse ( RN ) who comprehensively plans for case management of a target ... department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (11/07/25)
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  • Advanced Practice Provider (APP: NP/PA/CNS)…

    Stanford Health Care (Palo Alto, CA)
    …from an accredited college or university. + Nurse Practitioners, Clinical Nurse Specialists, Certified Registered Nurse Anesthetist: Master's or ... licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse Anesthetist).… more
    Stanford Health Care (12/16/25)
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  • Sr Specialist | PI - Quality & Safety | Quality…

    Sharp HealthCare (San Diego, CA)
    …in Patient Safety (CPPS) - Certification Board for Professionals in Patient Safety; California Registered Nurse ( RN ) - CA Board of Registered ... outcomes including responsibilities relating to leading teams in the utilization of Change Acceleration Process and PI tools and...Board for Professionals in Patient Safety -PREFERRED + California Registered Nurse ( RN ) - CA… more
    Sharp HealthCare (12/14/25)
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  • Quality Professional - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …- Days Department: QUALITY IMPROVEMENT Job Summary The Quality Professional is a Registered Nurse with clinical experience in Med/Surg, Critical Care and other ... methodologies; including data abstraction and analysis Licensure/Certification Requirements Required: + Registered Nurse licensed in State of New York Disclaimer… more
    Mohawk Valley Health System (12/10/25)
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