• Utilization Management Nurse Specialist RN…

    LA Care Health Plan (Los Angeles, CA)
    …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews...an acute hospital setting. At least 2 years of Utilization Management/ Case Management experience in a hospital… more
    LA Care Health Plan (12/20/25)
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  • RN/ Case Manager -MSH- Case

    Mount Sinai Health System (New York, NY)
    …in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager or a minimum of 3-5 years ... **Job Description** **RN/ Case Manager MSH Case ...a. Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management… more
    Mount Sinai Health System (12/23/25)
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  • Utilization Management Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    Manager appropriate information including, but not limited to, customer/ case issues, reports, trends/variances, action plans, etc. **SUPERVISORY RESPONSIBILITY:** ... & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health… more
    CareFirst (11/22/25)
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  • Inpatient Registered Nurse or Social Worker…

    St. Luke's University Health Network (Easton, 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 ... management, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all… more
    St. Luke's University Health Network (10/06/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …RN (Registered Nurse) + Preferred ACM ( Case Management) + Preferred CCM ( Case Manager ) **Education:** + Required Associates in Nursing or + Required ... concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary...Utilization Review or + Required 2 years in Case Management or + Required 3 years Registered Nurse… more
    BayCare Health System (10/10/25)
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  • RN Case Manager - Value Based…

    University of Southern California (Los Angeles, CA)
    …and evaluating their understanding of the process. Some of the major duties of the Case Manager overlap into inpatient duties including: Concurrent review of ... In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an… more
    University of Southern California (12/30/25)
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  • Case Manager / PRN ( RN / RT / SW…

    Select Medical (Anderson, SC)
    …ideas, providing high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, ... **Overview** **Select Specialty Hospital** **Critical Illness Recovery Hospital (LTACH)** ** Case Manager (PRN)** _Requires a current licensure in a clinical… more
    Select Medical (12/30/25)
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  • Social Worker - Inpatient Behavioral Health

    Garnet Health (Harris, NY)
    …effectively organize/prioritize accordingly, and implement evidence based care. Social Work Clinician/ Case Manager - primary role is to provide psychiatric/detox ... home with us as a Social Worker on our Inpatient Behavioral Health Unit (BHU) team at/in Garnet Health...plan. The SW Clinician will also be the primary Case Manager for the detox patient on… more
    Garnet Health (11/25/25)
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  • Case Manager - PRN

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target ... l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from… more
    Houston Methodist (11/07/25)
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  • Product Utilization Mgr.

    BJC HealthCare (St. Louis, MO)
    …work experience) **Additional Information About the Role** BJC HealthCare is seeking a Product Utilization Manager to join our team to assist with the operating ... its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace… more
    BJC HealthCare (12/23/25)
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