• Supervisor, Healthcare Services ( RN

    Molina Healthcare (North Las Vegas, NV)
    management or equivalent combination of relevant education and experience. * Registered Nurse ( RN ) Clinical licensure and/or certification required ONLY ... deadlines. * Excellent organizational, problem-solving and critical-thinking skills. Preferred Qualifications * Registered Nurse ( RN ). License must be active… more
    Molina Healthcare (01/02/26)
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  • Utilization Management Nurse

    US Tech Solutions (Hopewell, NJ)
    …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and… more
    US Tech Solutions (10/24/25)
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  • Director of Case Management

    Prime Healthcare (Inglewood, CA)
    …Workers, and Clinical Coordinators. This leader will oversee all facets of utilization management , discharge planning, and care coordination to ensure patients ... outcomes and reducing readmissions. #LI-CC2 Qualifications Required qualifications: 1. CA Registered Nurse 2. Bachelor's of Science in Nursing3. Grandfathered… more
    Prime Healthcare (12/24/25)
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  • Utilization Management Specialist…

    Penn Medicine (Lancaster, PA)
    …6:30am-9am. No holidays _Penn Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...assigned. **Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board… more
    Penn Medicine (12/24/25)
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  • Utilization Management Nurse

    CVS Health (Phoenix, AZ)
    …that promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
    CVS Health (12/13/25)
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  • Utilization Management

    Sanford Health (Rapid City, SD)
    …experience preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... providing direct supervision of all departmental staff. Maintains a standardization of utilization management process to ensure all policies and procedures are… more
    Sanford Health (12/17/25)
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  • RN , Hospital Case Manager/…

    Baystate Health (Springfield, MA)
    …- $62.85 **Per Diem Hospital Case Manager / Utilization Management ** The ** RN Hospital Case Manager** is a registered nurse responsible for the ... MD's about safe plan for transitions + Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate +… more
    Baystate Health (12/19/25)
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  • Coordinator Special Needs Waiver Populations,…

    CVS Health (Baton Rouge, LA)
    …it all with heart, each and every day. **Position Summary** The Utilization Management Coordinator/UMNC assists in ensuring that authorization request decisions ... children, ie generators, housing, rentals) * Collaborate with care management and utilization management teams...providers and goals are being met **Required Qualifications** * Registered Nurse (Required) * Ability to facilitate… more
    CVS Health (12/19/25)
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  • Clinical Registered Nurse

    Cognizant (Salem, OR)
    …have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
    Cognizant (12/23/25)
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  • RN - Case Manager - BSN -…

    John Muir Health (Walnut Creek, CA)
    …- Case Management Preferred or Equivalent Work Experience **Certifications/Licensures:** + RN Registered Nursing - California Board of NursingRequired + BLS ... the nursing practice with specialized focus on care coordination, compliance, transition management , education, and utilization management . **Education:** +… more
    John Muir Health (12/27/25)
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