• Utilization Review RN

    BayCare Health System (Tampa, FL)
    …Occasional + **On Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM ( Case Management) + Preferred CCM ... respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior / RN responsibilities include:** + Functions as the... Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical… more
    BayCare Health System (10/10/25)
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  • Senior RN Peer Review Specialist

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …works closely with CPR's Director and Clinical Lead, Operations Lead, Senior Credentialing Manager / Compliance Consultant, Risk Specialist, Exception Review ... Specialists and Project Manager . This position is eligible for our Resident, Mobile,...timely and accurate information on all cases in CPR's case management system (Access database) used for on-going monitoring,… more
    Blue Cross Blue Shield of Massachusetts (12/25/25)
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  • Clinical Care Manager or Senior

    UPMC (Pittsburgh, PA)
    …required (or must be obtained within 2 years of hire to remain in role) + Registered Nurse ( RN ) Licensure, Certifications, and Clearances: + LSW, CSW, LCSW ... facilities professional development project and activities as assigned in senior role. + Participates in case conferences,...in medical social work, home care, discharge planning, and case management required. + For Mobile Care Manager more
    UPMC (12/25/25)
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  • Senior Coordinator, Case Management

    Trinity Health (Columbus, OH)
    … Coordinator for Case Management, Mount Carmel East** **Position Purpose:** The Senior Case Management extender would work under the direction of the ... RN Care Managers, Utilization Review Care Manager ...Bachelor's degree preferred. + Medical assistant or Licensed Practical Nurse (LPN) highly preferred. + 5-7 years of customer… more
    Trinity Health (12/09/25)
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  • Quality RN

    CenterWell (North Charleston, SC)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... community and help us put health first** The Quality RN Professional responsible for the development, implementation and management...nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement +… more
    CenterWell (10/16/25)
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  • Senior Medical Management Nurse

    Ventura County (Ventura, CA)
    …link below: CNA_MOA_2023-2028.pdf (ventura.org) (https://vcportal.ventura.org/CEO/HR/MOA/docs/CNA\_MOA\_2023-2028.pdf) PAYROLL TITLE: Senior Registered Nurse ... - Ambulatory Care DISTINGUISHING CHARACTERISTICS: The Senior Registered Nurse -Ambulatory Care series is distinguished from...Managed Health Care Plan. + Experience working as a case manager in a health plan … more
    Ventura County (12/07/25)
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  • Quality RN - Hoffner

    CenterWell (Orlando, FL)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... and independent determination of the appropriate courses of action. The Quality RN Professional collaborates with market leadership, and quality improvement team to… more
    CenterWell (11/19/25)
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  • RN - Clinical Account Manager

    Blue KC (Workman, MN)
    …reports (eg, High-cost claimant reports, early warning reports, census reports, case management participant reports, etc.) to identify potential high-cost claimants, ... on requests for employer groups received by standard request processes for Case Management (CM) from Underwriting, client managers, sales team, brokers, etc. +… more
    Blue KC (11/08/25)
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  • Quality Improvement RN - New Smyrna/Daytona

    CenterWell (New Smyrna Beach, FL)
    …operational excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in Florida + 5+ ... and help us put health first** The Stars Improvement Clinical Professional ( RN ): + Collaborates with market leadership, and quality improvement team to developand… more
    CenterWell (10/16/25)
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  • Senior Discharge Plan Manager

    UPMC (Jamestown, NY)
    …Social Worker (LSW) OR Other Healthcare Professional Licenses for Discharge Planning OR Registered Nurse ( RN ) **UPMC is an Equal Opportunity ... RN or Social Worker interested in care management, case management, or care coordination? UPMC Chautauqua is looking...or care coordination? UPMC Chautauqua is looking for a ** Senior Discharge Plan Manager ** to support their… more
    UPMC (12/08/25)
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