• Utilization Review - Registered Nurse

    Community Health Systems (Naples, FL)
    **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical ... development of policies and procedures, standard work and educational materials for the UR department. Will be a partner with other staff members, providers, and… more
    Community Health Systems (07/12/25)
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  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …and appropriate exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care ... DME requests and inpatient readmissions. In collaboration with management, the UR nurse identifies potentially high-cost admissions and extended stays.… more
    CDPHP (08/03/25)
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  • Registered Nurse Case Manager

    Beth Israel Lahey Health (Exeter, NH)
    …outcomes. 3. Serves as a liaison among the patient, family members, physicians, nurse , social worker, UR nurse , insurance representative and community ... Registered Nurse Case Manager + Full Time + Exeter,...weekend per month (may change), alternating holiday rotation The Nurse Case Manager/Discharge Planner collaborates, facilitates and negotiates the… more
    Beth Israel Lahey Health (06/28/25)
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  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …at the right place at the right time. To accomplish these goals, the UR , Nurse applies established criteria to evaluate the appropriateness of admission, level ... + Five (5) years of health care experience as a Registered Nurse . **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse more
    UNC Health Care (06/05/25)
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  • Utilization Review Specialist Registered…

    Emory Healthcare/Emory University (Atlanta, GA)
    …Command Center at the Emory Northlake campus. Monday-Friday** The **Utilization Review ( UR ) Specialist** is a Registered Nurse responsible for conducting ... necessity reviews to assist with determining appropriate patient class designation. The UR Specialist will perform timely and comprehensive reviews of the patient… more
    Emory Healthcare/Emory University (08/19/25)
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  • Utilization Review Specialist / RN

    Emory Healthcare/Emory University (Atlanta, GA)
    …_development,_ and leadership programs + And more **Description** The **Utilization Review ( UR ) Specialist** is a Registered Nurse responsible for conducting ... reviews to assist with determining appropriate patient class designation. + The UR Specialist will perform timely and comprehensive reviews of the patient chart… more
    Emory Healthcare/Emory University (08/23/25)
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  • RN-Utilization Review Weekender Days

    Baptist Memorial (Meridian, MS)
    …of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure ... Description Title: RN Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness… more
    Baptist Memorial (07/21/25)
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  • RN-Utilization Review

    Baptist Memorial (Memphis, TN)
    …of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure ... Purpose of Position and Scope of Responsibility Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness… more
    Baptist Memorial (06/14/25)
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  • Program Mgr UR /Case Management - CMC…

    UTMB Health (Friendswood, TX)
    Program Mgr UR /Case Management - CMC - Clear Lake Center **Friendswood, Texas, United States** Nursing & Care Management UTMB Health Requisition # 2405887 The ... for the operational and personnel management of the UTMB UR /CM program. Serves as liaison and assists in the...Nursing + Current Texas Nursing Licensure as a Registered Nurse (RN). + Minimum of five (5) years full-time… more
    UTMB Health (08/01/25)
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  • Care Manager (UM/ UR ) - Remote, Idaho…

    Magellan Health Services (Boise, ID)
    …that directly influence quality of care. General Job Information Title Care Manager (UM/ UR ) - Remote, Idaho Licensed Grade 24 Work Experience - Required Clinical ... - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred… more
    Magellan Health Services (07/26/25)
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