• Primary Care Physician (PCP) - PRN

    STG International (Mountain Home, AR)
    …in the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's philosophy. ... patient safety. *Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health… more
    STG International (10/14/25)
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  • Primary Care Physician (PCP)

    STG International (Tupelo, MS)
    …in the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's philosophy. + ... safety. + Participates in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement… more
    STG International (10/08/25)
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  • Case Manager (NE)

    Charter Care Health Partners (North Providence, RI)
    …a specific patient population. Performs functions related to Patient Advocacy; Utilization Review ; Resource Management; Continuum of Care Management (Discharge ... (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode...recent experience with case management, patient navigation, case management, utilization review or discharge planning is strongly… more
    Charter Care Health Partners (10/18/25)
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  • Case Manager (NE)

    Charter Care Health Partners (North Providence, RI)
    …a specific patient population. Performs functions related to Patient Advocacy; Utilization Review ; Resource Management; Continuum of Care Management (Discharge ... (BSN preferred) with current license to practice as a Registered Nurse in the State of Rhode...recent experience with case management, patient navigation, case management, utilization review or discharge planning is strongly… more
    Charter Care Health Partners (10/18/25)
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  • Payment Integrity Clinician

    Highmark Health (Little Rock, AR)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
    Highmark Health (11/14/25)
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  • Manager, Nursing (H)

    University of Miami (Miami, FL)
    …or responsibilities as necessary. CORE QUALIFICATIONS + Bachelor's degree in relevant field + Registered Nurse Licensure ( RN ), BLS, and ACLS Provider Card. + ... to apply for a faculty or staff position, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The University of… more
    University of Miami (12/20/25)
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  • LTSS Coordinator - Nevada

    System One (Las Vegas, NV)
    …medical criteria and standards of care Licensure and Certification: + Current, unrestricted Registered Nurse ( RN ), Licensed Social Worker (LSW), or Licensed ... effective utilization of long-term services and supports through clinical review and benefits management. Essential Functions: + Serve as point of contact… more
    System One (12/19/25)
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  • Nurse Case Manager

    General Dynamics Information Technology (Hurlburt Field, FL)
    …Center. + Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, ... proof of all training/certs/documentation. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential… more
    General Dynamics Information Technology (10/26/25)
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  • PRN Clin Resource Coord in HUP ED

    Penn Medicine (Philadelphia, PA)
    …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources,… more
    Penn Medicine (12/20/25)
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  • Organizational Quality Nurse Specialist

    Hospice of Michigan (Ann Arbor, MI)
    …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical… more
    Hospice of Michigan (12/10/25)
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