• Utilization Management Specialist…

    Penn Medicine (Lancaster, PA)
    …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...**Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing +… more
    Penn Medicine (12/24/25)
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  • RN, Hospital Case Manager/ Utilization

    Baystate Health (Springfield, MA)
    …Midpoint - Maximum $46.22 - $53.13 - $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The **RN Hospital Case Manager** is a registered nurse ... MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate +… more
    Baystate Health (12/19/25)
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  • Coordinator Special Needs Waiver Populations,…

    CVS Health (Baton Rouge, LA)
    …it all with heart, each and every day. **Position Summary** The Utilization Management Coordinator/UMNC assists in ensuring that authorization request decisions ... children, ie generators, housing, rentals) * Collaborate with care management and utilization management teams...and goals are being met **Required Qualifications** * Registered Nurse (Required) * Ability to facilitate in-person and via… more
    CVS Health (12/19/25)
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  • Utilization Management Rep II

    Elevance Health (West Des Moines, IA)
    ** Utilization Management Representative II** **Location:** The selected candidate for this position must reside in Iowa. **_Virtual:_** This role enables ... an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
    Elevance Health (11/25/25)
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  • Utilization Management

    Elevance Health (Indianapolis, IN)
    **Title: Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required ... an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
    Elevance Health (01/01/26)
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  • Utilization Management

    Elevance Health (Costa Mesa, CA)
    ** Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
    Elevance Health (12/19/25)
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  • Utilization Management Coordinator…

    Saint Francis Health System (Tulsa, OK)
    …in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal ... Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or Professional Counselor (LPC)… more
    Saint Francis Health System (12/31/25)
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  • Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    management referrals. Initiates appropriate social work referrals. + Performs utilization management assessments and interventions, using collaboration with ... well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and...+ Must be licensed to practice as a Registered Nurse in the state of North Carolina or one… more
    UNC Health Care (12/24/25)
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  • Utilization Management RN Weekender

    Grace Hospital (Morganton, NC)
    …patients and their families ." THE POSITION Join our dynamic healthcare team as a Utilization Management RN Weekender, where you will play a vital role in ... Blue Ridge HealthCare Hospitals - Morganton Clinical Case Management THE ORGANIZATION At UNC Health Blue Ridge,...delivery. Must have licenses to practice as a Registered Nurse in North Carolina and have practiced 3 years… more
    Grace Hospital (12/06/25)
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  • Manager, Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... To provide leadership to integrated inpatient teams; assists Director in the management of department; including personnel and fiscal management and development… more
    Children's Mercy Kansas City (12/15/25)
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