• Utilization Review Specialist - RN

    Rochester Regional Health (Rochester, NY)
    Job Title: Utilization Review Specialist (RN) Department: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 Hours (Full-Time) ... Days SUMMARY:The Utilization Review Specialist actively participates in the utilization management of patients and evaluating hospital admissions with the… more
    Rochester Regional Health (10/07/25)
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  • Clinical Utilization Review Specialist

    Community Health Systems (Franklin, TN)
    … preferred + 2-4 years of clinical experience in utilization review, case management , or acute care nursing required + 1-3 years work experience in care ... and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission...Nursing required + Bachelor's Degree in Nursing more
    Community Health Systems (10/14/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
    University of Utah Health (10/02/25)
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  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    Utilization and Appeals Coordinator will perform activities to help facilitate utilization management and appeals functions to include coordination of ... payment related activities. Position Responsibilities: + Prepares necessary documentation for utilization management and appeals processes, performs data … more
    Catholic Health Services (09/09/25)
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  • Utilization Review Nurse

    Children's Hospital Los Angeles (Los Angeles, CA)
    …* 3+ years nursing experience (pediatric experience preferred) * Utilization management and/or discharge planning experience preferred * Strong knowledge ... rewarding. **It's Work That Matters.** **Overview** **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review… more
    Children's Hospital Los Angeles (10/14/25)
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  • Utilization Review Case Mgr - Galv. Campus…

    UTMB Health (Galveston, TX)
    …consumption, and achieve positive patient outcomes. + Educates the Medical Staff and Nursing Staff on Utilization Management and provides specific ... Utilization Mgt (10hr shifts) **Galveston, Texas, United States** Nursing & Care Management UTMB Health Requisition...school of professional nursing and current Texas Nursing licensure as a professional registered nurse .… more
    UTMB Health (09/24/25)
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  • Regional Utilization Review Documentation…

    Trinity Health (Maywood, IL)
    …in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We ... Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist** nurse works with...area of nursing granted by a national nursing organization preferred. + Case Management certification… more
    Trinity Health (10/01/25)
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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 ... completed the basic professional curricula of a school of nursing as approved and verified by a state board...and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or Professional… more
    Saint Francis Health System (10/08/25)
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  • Utilization Review Specialist

    CaroMont Health (Gastonia, NC)
    …fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments, Nursing departments, Care ... to practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management , Quality and/or Case Management preferred.… more
    CaroMont Health (10/11/25)
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  • RN - Utilization Management - Full…

    Sanford Health (Fargo, ND)
    …various other nursing interventions. Functions within the scope and standards of nursing practice as outlined in the Nurse Practice Act and Administrative ... ** **Job Summary** Provides expertise and leadership to ensure effective resource management for patient care delivery across the care continuum for assigned patient… more
    Sanford Health (09/24/25)
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