• Manager - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …of any of the following: CPHM (Certified Professional in Healthcare Management), CCM (Certified Case Manager ), ACM (Accredited Case Manager ) required or ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional...regulatory and health plan requirements for authorization, including Medicare Inpatient Only List and communicates to provider to obtain… more
    Minnesota Visiting Nurse Agency (12/06/25)
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  • Manager , Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …KS or MO Compact within 60 days of hire + One of the following: American Case Management, Certified Case Manager required upon hire + Employees must obtain ... of our hospital. Overview To provide leadership to integrated inpatient teams; assists Director in the management of department;...equivalent within 730 days + Employees must obtain Certified Case Manager or equivalent within 730 days… more
    Children's Mercy Kansas City (12/15/25)
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  • Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review ... met and care delivery is coordinated. The UM completes utilization reviews in accordance with federal regulations and the...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
    UNC Health Care (12/24/25)
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  • Inpatient Care Manager (RN): Per…

    Atlantic Health System (Morristown, NJ)
    …Nurse to join the energetic and innovative team of healthcare professionals as a Inpatient Care Manager on the Care Management Team at Morristown Medical Center. ... team to achieve optimal clinical and resource outcomes, work with the Supervisor/ Manager of Case Management to assess, plan, implement, coordinate, monitor… more
    Atlantic Health System (11/01/25)
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  • Registered Nurse Care Coordinator-…

    Cedars-Sinai (CA)
    …settings. In collaboration with the Inpatient Specialty Program (ISP) hospitalists, the Case Manager will assist patients from the time they are admitted ... Little More About What You Will be Doing** The Case Manager is responsible for the ...the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization more
    Cedars-Sinai (01/01/26)
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  • Case Manager II - Transition…

    Sharp HealthCare (San Diego, CA)
    …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Bachelor's Degree in Nursing; Master's Degree; Certified Case Manager (CCM) - Commission for ...or case management experience. + 3 Years case management, utilization review, care coordination experience.… more
    Sharp HealthCare (12/18/25)
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  • Case Manager I - Transition Planner…

    Sharp HealthCare (San Diego, CA)
    …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Certified Case Manager (CCM) - Commission for Case Manager ... Certification; California Registered Nurse (RN) - CA Board of Registered Nursing; Accredited Case Manager (ACM) - American Case Management Association… more
    Sharp HealthCare (11/09/25)
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  • Registered Nurse (RN) - Utilization

    Rochester Regional Health (Rochester, NY)
    …problem solving. ​ REQUIRED QUALIFICATIONS: + 3 years of acute hospital care, Case Management and/or Utilization Management experience + Excellent oral and ... Job Title: Registered Nurse I Department: Utilization Management Location: Rochester General Hospital Hours Per...(Full-Time) Schedule: Monday - Friday, Days SUMMARY: Review all inpatient medical necessity denials for the health system based… more
    Rochester Regional Health (12/31/25)
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  • RN Acute Case Manager - System Care…

    Guthrie (Sayre, PA)
    …clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the ... On Bonus For Qualified RNs! Position Summary: The Acute Case Manager utilizes industry accepted processes for...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case more
    Guthrie (12/25/25)
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  • Inpatient Registered Nurse (RN) or Social…

    St. Luke's University Health Network (Sellersville, PA)
    …to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge planning needs of patients, as ... including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates communication among all treatment… more
    St. Luke's University Health Network (12/31/25)
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