• Staff Nurse - Utilization Review (ED)

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …- REVISED FTE *_SUMMARY:_* We are currently seeking a*Staff Nurse*to join our Utilization Management department for the/Emergency Department / This position is ... *Assessment:* * Collects, reviews, and documents clinical data relevant to utilization management , including patient status, treatment plans, and healthcare… more
    Minnesota Visiting Nurse Agency (12/03/25)
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  • Utilization Review RN - Patient Bus Svs

    St. Peters Health (Helena, MT)
    The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR team members in ... collaborative and supportive liaison and educator to providers and staff around utilization management principles. This professional role will be responsible… more
    St. Peters Health (12/11/25)
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  • RN - Utilization Review

    UnityPoint Health (Cedar Rapids, IA)
    …174223 Overview This position is on site at St. Luke's Hospital. The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH HODs effective… more
    UnityPoint Health (11/07/25)
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  • Director Utilization Management

    Healthfirst (NY)
    …maintain and improve department performance** + **Collect, analyze, and report on utilization trends, patterns, and impacts to identify areas for improvement** + ... closely with other Operations leaders including but not limited to Care Management , Clinical Eligibility, Behavioral Health, and Appeals and Grievances teams to… more
    Healthfirst (12/04/25)
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  • Utilization Review Coordinator

    Community Health Systems (Franklin, TN)
    …preferred **Knowledge, Skills and Abilities** + Strong knowledge of utilization management principles, payer requirements, and healthcare regulations. ... Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals… more
    Community Health Systems (12/10/25)
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  • Senior Utilization Review Medical Director

    Integra Partners (Troy, MI)
    …Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is a full-time, 40+ ... quality and inter-rater reliability, overseeing audit readiness, and chairing Integra's Utilization Management Committee and Credentialing Committee. This role… more
    Integra Partners (12/03/25)
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  • ABA Utilization Review (UR) Specialist

    Spectrum Billing Solutions (Skokie, IL)
    …billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | ... Review Specialist | ABA Utilization Review Specialist | ABA Utilization Management Specialist | ABA UR Specialist | Behavioral Health Billing Specialist… more
    Spectrum Billing Solutions (10/30/25)
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  • Utilization Review Case Mgr - CMC - Clear…

    UTMB Health (Webster, TX)
    …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
    UTMB Health (12/12/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
    University of Utah Health (10/02/25)
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  • Coordinator of Pharmacy Benefits - Fulltime…

    Henry Ford Health System (Troy, MI)
    …other delegated pharmacist. Facilitates the operations of the Pharmacy Care Management Department by organizing, improving, and implementing pharmacy benefit ... management policies and procedures. Major areas of responsibility include...Additional Information + Organization: Community Care Services + Department: Pharmacy- Utilization Mgmt + Shift: Day Job + Union Code:… more
    Henry Ford Health System (12/08/25)
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