- Centene Corporation (Sacramento, CA)
- …to performance, compliance , quality, and efficiency standards + Collaborates with utilization management team to resolve complex care member issues + ... years of related experience. Knowledge of utilization management principles preferred. 25% Travel CA RN ...Travel CA RN License Required **License/Certification:** + RN - Registered Nurse -… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) ... Utilization Review Nurse Coordinator (40 Hour)...(https://www.elicense.ct.gov/) online (expand the 'Public Health Practitioners' grouping, select ' Registered Nurse ' and then 'Start'; + Request… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment...+ + Introduction Are you a skilled and experienced Registered Nurse ( RN ) ? Join our ... LICENSE, PLEASE: + Review the eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) for CT license by… more
- Amergis (Santa Rosa, CA)
- …coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical ... RN licensure in state practicing + At least one year of Case Management experience preferred + Current CPR if applicable + TB questionnaire, PPD or chest x-ray… more
- Northeast Alabama Regional Medical Center (Anniston, AL)
- Under the direction of the Case Management Coordinator, coordinates, negotiates, procures and manages the care of patients to facilitate achievement of positive ... care as appropriate. Participates in performance improvement initiatives related to the management of patient care. Works with physicians to ensure accurate and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- **12/2/2025 - REVISED FTE *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / ... needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Master's Degree in Nursing; Bachelor's Degree in Nursing; Master's Degree; California Registered Nurse ( RN ) - CA Board of Registered ... or clinical experience in area of specialty. + California Registered Nurse ( RN ) - CA...and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for… more
- Alameda Health System (Oakland, CA)
- Director, Utilization Management + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + Nursing + Req #:40826-30155 + ... plans **Role Overview:** Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight,… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more