• Licensed Physician Reviewer - Ortho (remote)

    ChenMed (Miami, FL)
    …our team. The Physician Reviewer is the primary physician reviewer for Utilization Management /Clinical Appropriateness review cases in our organization. Other ... Process and Quality improvement in our developing area of Delegated Utilization Management . **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated… more
    ChenMed (10/16/25)
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  • Assessment Specialist PRN

    HCA Healthcare (Nashville, TN)
    …required (LPC, LMFT, LCSW, LADAC) + Previous experience in Needs Assessment and Utilization Management strongly preferred. + Familiarity with required DSM V-R ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...want to create your own personal career path in nursing ? HCA Healthcare is your career destination! Our scale… more
    HCA Healthcare (11/10/25)
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  • Home Health Professional Staff Nurse - Cole

    UPMC (Coudersport, PA)
    …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... UPMC Home Health is hiring a Registered Nurse for the area. Are you a ...and compassionate registered nurses to join our home health nursing team! You'll work in a home setting with… more
    UPMC (09/13/25)
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  • Onsite Clinical Navigator (Hybrid)

    CareFirst (Baltimore, MD)
    …home or other levels of care. Utilizing experience and skills in both care management and utilization management , the Onsite Clinical Navigator will leverage ... Required. **Experience:** 5 years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review.… more
    CareFirst (10/09/25)
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  • Clinical Manager, Behavioral Health (UM)…

    Magellan Health Services (Boise, ID)
    …the management , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care ... management staff, providing expertise in designated programs. + Assists clinical management in the development and on-going management of designated staff. +… more
    Magellan Health Services (10/17/25)
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  • Registered Nurse (On call)

    MTC (Quincy, FL)
    …record or other forms as appropriate. + Practice basic cost containment and utilization management for inmate care and facility operations. + Maintain absolute ... 7pm or 7pm-7am **ARE YOU BURNT OUT ON BEDSIDE NURSING ?? Give correctional nursing a try! This...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
    MTC (10/31/25)
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  • Registered Nurse (RN) Case Manager - OMC…

    Ochsner Health (New Orleans, LA)
    …of hospital-based experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered nurse license in ... to develop and implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case Management OMC Jefferson Highway PRN… more
    Ochsner Health (10/29/25)
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  • Registered Nurse

    MTC (Marion, OH)
    …the use of appropriate sanitation methods. 6. Practice basic cost containment and utilization management for patient care and facility operations. 7. Maintain ... + Civic duty and military leave Impact lives with Management & Training Corporation (MTC)! At the **North Central...accredited **high school or equivalent (GED).** + **Degree in nursing and current valid nursing license in… more
    MTC (11/08/25)
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  • Director of Nursing

    Sevita (TN)
    …every day. Join us today, and experience a career well lived. **State Nursing Director - IDD Services (Registered Nurse )** **_Starting Pay: $110,000_** ... state strategy to increase census, maintain occupancy, improve daily attendance, and maximize utilization . + Financial Management : + May be responsible for the… more
    Sevita (09/09/25)
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  • Inpatient Registered Nurse or Social Worker…

    St. Luke's University Health Network (Easton, PA)
    …, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among ... National Organization of Perinatal Social Workers is required. OR: Graduate of professional nursing program. Registered Nurse with current license to practice in… more
    St. Luke's University Health Network (10/06/25)
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