• Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Columbia, SC)
    …the continuum of care. Responsibilities The Community Care Nurse (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined ... of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (01/07/26)
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  • Home Health Weekend Registered Nurse

    UPMC (West Mifflin, PA)
    UPMC Home Health is Hiring a Full-Time Weekend Registered Nurse ( RN ) Are you a nurse looking for a rewarding career where you can provide direct, ... establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and… more
    UPMC (12/12/25)
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  • PACU Registered Nurse FLOAT

    Katmai (Fort Carson, CO)
    …all levels of health care management to include outside agencies. Performs utilization management activities to optimize cost, quality, and access to care. ... **Job Requirements:** **MINIMUM QUALIFICATIONS** + Associates Degree of Nursing. Registered nurse shall be a graduate from...+ Shall possess a current, active, full and unrestricted Registered Nurses ( RN ) licensed in Colorado or… more
    Katmai (12/13/25)
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  • Integrated Care Management Assistant Case…

    McLaren Health Care (Port Huron, MI)
    …between patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure that ... **Schedule:** **Position Summary:** Responsible for providing assistance to the RN and SW Care Managers in the coordination of...a HealthCare related field * Two years of case management or utilization review experience * Three… more
    McLaren Health Care (01/03/26)
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  • Practice Site Manager RN Registered

    Penn State Health (State College, PA)
    …prohibit or outlaw discrimination._ **Union:** Non Bargained **Position** Practice Site Manager RN Registered Nurse - Windmere Centre **Location** ... + Five (5) years of related experience required. + Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN more
    Penn State Health (12/23/25)
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  • Registered Nurse - Acute Care…

    Aspirus Ironwood Hospital (Duluth, MN)
    …values Every. Single. Day. ASPIRUS ST. LUKE'S HOSPITAL in Duluth, MN is seeking a REGISTERED NURSE - ACUTE CARE COORDINATOR to join our CARE COORDINATION team! ... ensuring implementation and monitoring of compliant documentation strategies and utilization management principles. MINIMUM QUALIFICATIONS + Education: Graduate… more
    Aspirus Ironwood Hospital (12/27/25)
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  • RN Case Manager - Care Coordination - Full…

    University of Southern California (Arcadia, CA)
    …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation, and discharge planning functions. The ... to resolve problems with payers as needed. + Completes utilization management for assigned patients. + Coordinates/facilitates.... Licenses and Certifications Minimum (Required) * A current RN licensure in the State of California is required.… more
    University of Southern California (11/19/25)
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  • Quality Review Nurse (Hybrid)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The role of the Nurse , Quality Review Utilization Management (UM) is to evaluate clinical quality and procedures ... within the Utilization Management (UM) program to maximize efficiency,...required work experience. **Licenses/Certifications Upon Hire Required:** + Health Services\ RN - Registered Nurse -… more
    CareFirst (12/30/25)
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  • Registered Nurse III

    MTC (Raymondville, TX)
    …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... Detention Facility in Raymondville, TX** is seeking a dedicated RN to provide compassionate care and support to individuals...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
    MTC (01/01/26)
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  • RN Clinical Appeals Nurse Remote

    Molina Healthcare (WI)
    …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support...officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports… more
    Molina Healthcare (01/02/26)
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