• 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 ... a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses...**Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah,… more
    University of Utah Health (01/06/26)
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  • Utilization Review Case Mgr - CMC - Clear…

    UTMB Health (Webster, TX)
    …testing is also required. **_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of three (3) years ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
    UTMB Health (12/12/25)
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  • Utilization Management Coordinator…

    Saint Francis Health System (Tulsa, OK)
    …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or ... in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of internal… more
    Saint Francis Health System (12/31/25)
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  • Utilization Mgmt Nurse RN

    Truman Medical Centers (Kansas City, MO)
    …Schedule** 7:30AM - 4:00PM **Hours Per Week** 40 **Job Description** The Utilization Management Nurse (UM RN ) collaborates with members of the healthcare ... into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Mgmt Nurse RN -...then a graduate degree in Nursing is required + Registered Nurse licensed in state of Missouri,… more
    Truman Medical Centers (12/09/25)
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  • RN Utilization Review Full- time…

    Providence (Mission Hills, CA)
    Utilization Management , medical necessity, and patient status determination. The Utilization Management RN must effectively and efficiently manage a ... **Description** Provide prospective, retrospective, and concurrent utilization reviews for our LA ministries. Conduct clinical...**Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2… more
    Providence (12/16/25)
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  • RN - Utilization Review - *EVENINGS

    Providence (Olympia, WA)
    …a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. ... must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years -...or Associate's Degree in Nursing + 3 years - Utilization Review, Care Management , Quality Management more
    Providence (12/18/25)
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  • Quality/ Utilization Review Nurse

    George C. Grape Community Hospital (Hamburg, IA)
    …infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. * ... Quality/ Utilization Review Nurse Position Summary: The...& Collaboration: o Educate clinical staff on documentation requirements, utilization management processes, and infection control standards.… more
    George C. Grape Community Hospital (11/25/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …Day (United States of America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management , Quality Screening and Delay Management for ... assigned patients. * Completes Utilization Management and Quality Screening for assigned patients.* Applies MCG...with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State… more
    Albany Medical Center (12/03/25)
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  • Utilization Management Nurse

    US Tech Solutions (Columbia, SC)
    …the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more
    US Tech Solutions (12/24/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    …compliance. + Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in denials, approvals, ... you? + Minimum of 2-3 years of experience in utilization review, case management , or insurance coordination...a related field required; advanced degree or licensure (eg, RN , LCSW, LPC, LMHC, or CADC) preferred. + Excellent… more
    BriteLife Recovery (01/05/26)
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