• Registered Nurse (Non-Practicing)…

    Ivyhill Technologies LLC (Bethesda, MD)
    Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center ... referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of First… more
    Ivyhill Technologies LLC (06/09/25)
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  • Utilization Management Nurse

    Actalent (Des Moines, IA)
    Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a diligent and detail-oriented Post Review Nurse to perform timely ... cross-functional collaboration across divisions. + Provide backup support to other UM teams, including precertification and continued stay reviews. + Facilitate… more
    Actalent (09/04/25)
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  • Nurse Care Coordinator

    Catholic Health Initiatives (Roseburg, OR)
    …optimizing care transitions and ensuring positive patient outcomes? We're seeking a skilled ** Nurse Care Coordinator** to join our team in Oregon, where you'll play ... field preferred) + Experience or certification in case management (CCM, ACM, UM Cert preferred) **Overview** CHI Mercy Health offers the unique opportunity to… more
    Catholic Health Initiatives (08/31/25)
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  • Registered Nurse - Utilization Review

    HonorHealth (AZ)
    …in Nursing from an accredited NLN/CCNE institution - RequiredExperience 1 year experience in UR/ UM or Case Management - Required 3 years as a Registered Nurse ... in an acute care setting - RequiredLicenses and Certifications Registered Nurse (RN) State And/Or Compact State Licensure - Required Certified Case Management (ACM)… more
    HonorHealth (08/22/25)
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  • Registered Nurse

    US Tech Solutions (Wichita, KS)
    …Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior authorization utilization experience + ... + MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION… more
    US Tech Solutions (08/08/25)
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  • Registered Nurse - Utilization Management

    ERP International (Barksdale AFB, LA)
    **Overview** ERP International is seeking a **Utilization Management Registered Nurse (RN)** for a full-time position supporting the 2d Medical Group, Barksdale AFB, ... management policies to manage internal and external referrals. Incorporate UM strategies as part of the referral management center's...Management is required. Full time employment as a registered nurse within the last 36 months is mandatory. Six… more
    ERP International (06/18/25)
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  • Denials Management Nurse

    Catholic Health Initiatives (Little Rock, AR)
    …related healthcare field Minimum three (3) years clinical experience as Registered Nurse (RN) 5 years of RN experience **Preferred** Denials management experience ... experience strongly preferred Care Management certification (CCM or ACM) or UM Certification _While you're busy impacting the healthcare industry, we'll take… more
    Catholic Health Initiatives (08/31/25)
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  • Registered Nurse (RN) - Utilization Review,…

    Dartmouth Health (Lebanon, NH)
    …care. Actively involved in discharge planning process. * Inpatient psych UM experience preferred Responsibilities * Works with Medical Director and appropriate ... communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote:Fully Remote * Area of… more
    Dartmouth Health (08/30/25)
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  • Registered Nurse -Utilization Management…

    McLaren Health Care (Pontiac, MI)
    …treatment. 6. Documents future discharge needs in EMR for continued communication with ICM UM RN and Care Management staff 7. Assesses if follow up treatment, or ... other duties as assigned. #LI-AK1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited educational institution, or… more
    McLaren Health Care (08/29/25)
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  • Community Health Assessment Field Nurse…

    Excellus BlueCross BlueShield (Rochester, NY)
    …the use of medical and health care services for members. The SN CHA Nurse may also perform other technical and administrative tasks essential to the efficient ... required. + Broad understanding of multiple areas, including but not limited to UM and CM, Fair Hearings and Appeals/Grievances, within three months of working in… more
    Excellus BlueCross BlueShield (08/19/25)
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