• Utilization Review & Chronic Care…

    George C. Grape Community Hospital (Hamburg, IA)
    Utilization Review & Chronic Care Management (CCM) Nurse George C. Grape Community Hospital & Clinics is seeking a full-time Utilization Review & ... this position, you'll split your time between: * Hospital Utilization Review - Conduct daily face-to-face rounds...ensure documentation supports medical necessity. * Clinic Chronic Care Management - Work with patients who have multiple chronic… more
    George C. Grape Community Hospital (08/16/25)
    - Related Jobs
  • Utilization Review Nurse

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,...state, local, and federal programs + Progressive knowledge of utilization management , case management , performance… more
    Houston Methodist (07/12/25)
    - Related Jobs
  • Utilization Management Nurse

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (08/27/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical… more
    CVS Health (08/27/25)
    - Related Jobs
  • Utilization Management Nurse

    CVS Health (Boise, ID)
    … (RN) - active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have ... procedures/services or initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to… more
    CVS Health (08/15/25)
    - Related Jobs
  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management more
    The County of Los Angeles (08/18/25)
    - Related Jobs
  • Utilization Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The ...Skills + Clinical review + Utilization review + Utilization management + Interqual ... Utilization Management Nurse (UMN) plays a crucial role in reviewing service...+ Valid Florida Driver's License. + Knowledge of case management and utilization review concepts,… more
    Actalent (08/21/25)
    - Related Jobs
  • Utilization Review Nurse

    Emory Healthcare/Emory University (Decatur, GA)
    …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / ... . This individual will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization more
    Emory Healthcare/Emory University (08/22/25)
    - Related Jobs
  • Utilization Review Nurse

    Martin's Point Health Care (Portland, ME)
    …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care… more
    Martin's Point Health Care (08/22/25)
    - Related Jobs
  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem ... Registered Nurse II/III - Utilization Management ...as needed to assist with patient care coordination and utilization review . The incumbent will be responsible… more
    Ventura County (08/10/25)
    - Related Jobs