- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... financial, and utilization goals through effective management , communication, and...in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National… more
- George C. Grape Community Hospital (Hamburg, IA)
- …infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. * ... Quality/ Utilization Review Nurse Position Summary: The...& Collaboration: o Educate clinical staff on documentation requirements, utilization management processes, and infection control standards.… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Nov 30, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
- Saint Francis Health System (Tulsa, OK)
- …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or ... and benefits of patients, matching the level of care utilization . Assures compliance with Managed Care Behavioral...nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location: Tulsa,… more
- Sharp HealthCare (La Mesa, CA)
- …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
- Catholic Health Initiatives (Omaha, NE)
- **Job Summary and Responsibilities** As a Utilization Management Assistant you will receive, process, facilitate and document all payer communications. This ... ensure the accurate submission of clinical documentation to third party payers. The Utilization Management Assistant supports the Utilization Management … more
- US Tech Solutions (May, OK)
- …of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF UTILIZATION … more
- Elevance Health (Washington, DC)
- …clinical operations areas including regulatory and accreditation, compliance and quality management . + Must have prior utilization management leadership ... located at 609 H. Street NE.** The **Manager of Utilization Management ** **ll** is responsible for managing...types covered by the health plan. + Ensures continued compliance with specific medical management standards. +… more
- Albany Medical Center (Albany, NY)
- …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… more
- Actalent (Minnetonka, MN)
- Utilization Management Nurse Job Description As a Utilization Management Nurse for Post Acute care, you will be responsible for reviewing and ... to assess the medical necessity of post-acute stays. Essential Skills + Expertise in utilization management and utilization review. + Experience in acute… more