• RN Utilization Review Specialist Per Diem

    HonorHealth (AZ)
    …an acute care setting. Required1 year experience in UR/UM or Case Management RequiredLicenses and CertificationsRegistered Nurse (RN) State And/Or Compact State ... -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of health… more
    HonorHealth (11/04/25)
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  • Care Manager (Remote)

    CareFirst (Baltimore, MD)
    …Washington. **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review, Disease ... **PURPOSE:** This position will support the Maryland government programs care management team, specifically the Medicare Advantage line of business. The Care… more
    CareFirst (10/10/25)
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  • Case Manager Registered Nurse | Care…

    CentraCare (St. Cloud, MN)
    …Job Category: Clinical Professional Job Schedule: Full time Join the inpatient care management team as an Registered Nurse Case Manager. Support our patients ... an integral part of the St. Cloud Hospital Case Management System, the Registered Nurse Case Manager...transitional needs, monitor length of stay, and promote efficient utilization of resources. Facilitates the collaborative management more
    CentraCare (11/20/25)
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  • Nursing Director, Administration (Director,…

    The County of Los Angeles (Los Angeles, CA)
    NURSING DIRECTOR, ADMINISTRATION (Director, Workforce Management and Operations) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3110377) ... Apply  NURSING DIRECTOR, ADMINISTRATION (Director, Workforce Management and Operations) Salary $163,996.80 - $255,048.48 Annually Location Los Angeles County,… more
    The County of Los Angeles (09/03/25)
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  • RN Appeals Reviewer

    Adecco US, Inc. (Minneapolis, MN)
    …. Experience applying benefits and criteria to clinical reviews . Utilization Management , pre-authorization, concurrent review, or appeals experience **Why ... law; and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This **Registered Nurse ** role is being recruited for by Adecco's Healthcare & Life Sciences… more
    Adecco US, Inc. (11/21/25)
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  • Physician (Nephrology)

    Veterans Affairs, Veterans Health Administration (Orlando, FL)
    …coordination for all patients in the dialysis unit- outpatient clinics- Inpatients with utilization management team and case managers and effectively work with ... care plan. Collaborate and communicate effectively and timely with the clinical nursing staff- peers- other Subspecialty providers and leadership Participate in care… more
    Veterans Affairs, Veterans Health Administration (11/21/25)
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  • Behavioral Health Care Manager II

    Elevance Health (FL)
    …Licensure is a requirement for this position. + Previous experience in case utilization management with a broad range of experience with complex ... work counseling or a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with facility-based and/or outpatient psychiatric… more
    Elevance Health (11/11/25)
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  • Pharmacy Clinical Review Specialist, Rx Partners

    UPMC (Bridgeville, PA)
    …coordination of benefits, complaints and grievance guidelines and prescription drug utilization management required + Thorough knowledge in MS Office ... licensed pharmacist. This position provides customer service to Rx Partners Skilled nursing and Hospice clients. The clinical review specialist at Rx Partners works… more
    UPMC (10/30/25)
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  • Behavioral Health Therapist PRN Behavioral Health…

    LifePoint Health (Las Cruces, NM)
    …diagnostic reasoning, clinical decision making, patient/family education, consultation, counseling, utilization management , and discharge planning. * Graduate ... from a university program in Psychology, Counseling, Social Work, Nursing , or MSW. * TTwo (2) recent years clinical experience preferred. * Duties will include… more
    LifePoint Health (09/16/25)
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  • Utilization Coordinator - Homecare

    BayCare Health System (Largo, FL)
    …Preferred Case Management Certification **Education:** + Required associate's degree in nursing or nursing diploma **Experience:** + Required - One Year Case ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Coordinator(Homecare) responsibilities include:** + Coordinates utilization ... Management + Required - One Year Homecare **Benefits:** +… more
    BayCare Health System (09/04/25)
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