• Manager - Patient Services - Ventura County Health…

    Ventura County (Ventura, CA)
    …of experience in managed care + Must possess and maintain a valid license as a Registered Nurse Issued by the State of California Board of Registered Nurses ... Utilization Management, Quality Management, Case Management, and Disease Management ( UM , QM, CM, and DM); + Oversees complex tasks...have a current, active and valid State of California Registered Nurse license? If yes, you MUST… more
    Ventura County (09/09/25)
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  • Utilization Management Nurse - Behavioral…

    Omaha Children's Hospital (Omaha, NE)
    …management. + Should be a creative, flexible, risk taker. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... and people with disabilities. **A Brief Overview** Utilization Management ( UM ) is a specialty area of Nursing Case Management...Licensure Required and + RN -BC - Case Management Nurse Preferred Children's… more
    Omaha Children's Hospital (09/05/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Lansing, MI)
    …during shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + 1+ ... promote high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse Consultant - Oncology and Transplant to join our remote… more
    CVS Health (09/12/25)
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  • Utilization Management Nurse Lead

    Humana (Lansing, MI)
    …in or be willing to relocate to the state of Michigan.** + An active, unrestricted registered nurse ( RN ) license in the state of Michigan. + Bachelor's ... community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent critical thinking… more
    Humana (08/20/25)
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  • Director Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …groups and clinical committees. Essential Qualifications + Active and unrestricted license as a Registered Nurse ( RN ). + Bachelor's degree in nursing, (or ... About The Role The Director, Utilization Management ( UM ) will manage the Utilization Management team consisting...drive day to day operations and oversight of the UM program. + Lead, develop and manage processes to… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Manager Integrated Case Mgmt-SCMG…

    Sharp HealthCare (San Diego, CA)
    …Time** **Shift End Time** Bachelor's Degree in Nursing; Bachelor's Degree; Master's Degree; California Registered Nurse ( RN ) - CA Board of Registered ... + Bachelor's Degree in Nursing Or + Bachelor's Degree in Healthcare Administration. + California Registered Nurse ( RN ) - CA Board of Registered Nursing… more
    Sharp HealthCare (08/29/25)
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  • Staff Nurse - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the medical ... the use of healthcare services, procedures, and facilities. The RN conducts timely reviews of inpatient and outpatient medical.../*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of… more
    Minnesota Visiting Nurse Agency (09/13/25)
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  • Senior Manager, Behavioral Health Utilization…

    Centene Corporation (Phoenix, AZ)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... with applicable guidelines + Reviews and analyzes BH utilization management ( UM ) activities, over/under utilization, operations, costs, and forecasted data to… more
    Centene Corporation (09/14/25)
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  • Social Work Manager

    HCA Healthcare (Englewood, CO)
    …Licensure/Certification/Registration: o Current licensure in the State of Colorado as a Registered Nurse , or current active multistate nursing licensure, or LCSW ... American Heart Association or American Red Cross required. o UM /CM certification preferred. B. Education: o Graduate of an...Science in Nursing and/or Master's level degree preferred for RN & MSW required for social work. C. Experience:… more
    HCA Healthcare (08/08/25)
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  • Home Health Admissions Nurse Beaver County

    UPMC (Seven Fields, PA)
    UPMC Home Health is Hiring a Full-Time Admissions Registered Nurse ( RN ) in the Beaver County and surrounding areas! UPMC Home Health is seeking a skilled and ... + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) OR Temporary Practice Permit (TPP) + Act… more
    UPMC (09/06/25)
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