• Clinical Denials Prevention & Appeals Specialist…

    Nuvance Health (Danbury, CT)
    …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum ... members of the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care reimbursement. Working… more
    Nuvance Health (12/10/25)
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  • Quality Coordinator RN - Full Time - Days

    Mohawk Valley Health System (Utica, NY)
    …Department: CARE MGMT SVCS Job Summary As a member of the MVHS Care Management clinical team, the Quality Coordinator RN uses patient-centered assessments and ... + Current RN license from the NY State Board of Registered Nursing. + Current CPR certification. Disclaimer Qualified applicants will receive consideration for… more
    Mohawk Valley Health System (12/10/25)
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  • RN Case Manager

    Amergis (Fairfield, CA)
    …coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical ... state practicing + At least one year of Case Management experience preferred + Current CPR if applicable +...RN License + Minimum 2 years of Case Management experience + Experience with EPIC EMR + BLS… more
    Amergis (11/07/25)
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  • Case Manager D- RN

    WMCHealth (Margaretville, NY)
    Case Manager D- RN Company: Margaretville Hospital City/State: Margaretville, NY Category: Nursing/Nursing Management Department: Case Management Union: No ... and service of selected patients across the health care continuum. Promotes effective utilization of resources and the highest quality of care for optimal clinical… more
    WMCHealth (12/02/25)
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  • RN Case Manager - Barnes-Jewish West County…

    BJC HealthCare (St. Louis, MO)
    …to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to ... Coeur, MO 63141 + At least 2 years of RN experience + BSN + At least 1 year...connects to Millennium Park. Care Coordination consist of Case Management , Social Services and Utilization Review. The… more
    BJC HealthCare (10/05/25)
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  • RN Care Coordinator

    Highland Hospital (Rochester, NY)
    …771 - Social Work Service **Job Description:** Highland Hospital is seeking an experienced RN to join the Care Management team. Care coordinators are responsible ... of patient progress toward goals for all patients followed 4. Disease specific management to reduce readmissions. 5. Identifies goals and usual patterns of care for… more
    Highland Hospital (12/05/25)
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  • RN Case Manager - Clinical Res Mgmt

    Tenet Healthcare (Commerce Township, MI)
    …planning experience. Preferred: Acute hospital case management experience. Required: RN . Must be currently licensed, certified, or registered to practice ... RN Case Manager - Clinical Res Mgmt -...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
    Tenet Healthcare (12/03/25)
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  • RN Case Manager

    Amergis (Hyannis, MA)
    …service delivery, and compliance with medical regime. Minimum Requirements: + Current RN licensure in state practicing + At least one year of Case Management ... Position: RN - Case Manager Location: Hyannis, MA Facility Type:...in hand - 3 years of acute care case management experience in the last 5 years - Exp in… more
    Amergis (12/03/25)
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  • Manager Care Coordination RN

    Dignity Health (Las Vegas, NV)
    …and experience + Minimum of 3 years of clinical care coordination experience, ( Utilization Management , Denial Management , Care Coordination) or 3 years ... **Where You'll Work** HelloHumankindness (https://www.dignityhealth.org/hello-humankindness) **Is your experience in Case Management as an RN in acute care with… more
    Dignity Health (11/01/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    …responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is ... delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare… more
    Brockton Hospital (12/12/25)
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