• Case Management Coordinator RN

    Catholic Health Initiatives (Lisbon, ND)
    …+ 3-5 year's current clinical experience in acute care settings + Prior Case Management / Utilization Review **Where You'll Work** CHI Lisbon Health is a ... **Job Summary and Responsibilities** As a Case Management Professional, you will be a pivotal coordinator...planning team. + Documents discharge planning as an ongoing review . + Monitors and coordinates swing bed referrals. +… more
    Catholic Health Initiatives (12/19/25)
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  • RN Case Manager

    HCA Healthcare (Gainesville, FL)
    …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North Florida ... with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more
    HCA Healthcare (01/08/26)
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  • Case Manager PRN

    HCA Healthcare (Gainesville, FL)
    …Case Management is preferred + BSN is preferred + Certification in Case Management , Nursing or Utilization Review is preferred HCA Florida North Florida ... with physicians, patients, families, hospital staff, and outside agencies + Performs utilization management reviews and communicates information to third party… more
    HCA Healthcare (01/07/26)
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  • Sr Manager Clinical UM Operations

    Healthfirst (NY)
    …oversight and operational management for all utilization management functions, including prior authorization, concurrent review , and service requests ... efforts for audits, performance improvement plans, and corrective actions related to utilization management + Foster a culture of accountability, professional… more
    Healthfirst (11/27/25)
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  • Intensive Community Manager, Complex Care (RN)

    ChenMed (Cleveland, OH)
    …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The incumbent in ... assist in achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from admission through… more
    ChenMed (12/04/25)
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  • Behavioral Health Care Manager I

    Elevance Health (Atlanta, GA)
    …services only, and there is licensed staff supervision. Previous experience in case management / utilization management with a broad range of experience with ... ​ **Preferred Skills, Capabilities and Experiences:** + Experience in behavioral health utilization management is highly preferred. + Exceptional at multitasking… more
    Elevance Health (01/10/26)
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  • RN Case Manager - Barnes-Jewish West County…

    BJC HealthCare (St. Louis, MO)
    …through the grounds and connects to Millennium Park. Care Coordination consist of Case Management , Social Services and Utilization Review . The personnel in ... to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to… more
    BJC HealthCare (01/03/26)
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  • Clinical Care Coordinator

    Kaleida Health (Williamsville, NY)
    …plans/care paths are addressed and met. Serve as liaison to ancillary and utilization review services, serve as communication link between health team members. ... planning, case management and home care required. Knowledge of Utilization Management . Use of computer applications related to health care industry as well… more
    Kaleida Health (12/31/25)
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  • Care Manager - Registered Nurse

    Crouse Hospital (Syracuse, NY)
    …of hospital resources while maintaining the quality of care. + Participates in the utilization management process using standards of care to determine the most ... Coordination Services team is hiring a Care Manager to review the services delivered to patients and compare it...- Five (5) years acute hospital experience. + Case Management or Utilization Management experience… more
    Crouse Hospital (12/31/25)
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  • Regional VP, Health Services

    Humana (Tallahassee, FL)
    …health initiatives. + Collaborate with various operational functions in the centralized utilization management team and other shared services. + Participate in ... data (eg Quality measures, Risk Adjustment ratings, chronic condition management , PCP visit rates and effectiveness, and member engagement...quality governance, peer review , and grievance resolution processes. Innovation & Transformation: +… more
    Humana (12/31/25)
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