- HCA Healthcare (Manchester, NH)
- …or Social Work. + MSW preferred. Experience: + Minimum of two years' experience in case management and/or utilization management preferred, or relevant ... What you will do in this role: + You will work collaboratively with RN case managers, acute care nurses, physicians, insurance companies, and other staff… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... /care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and… more
- Beth Israel Lahey Health (Needham, MA)
- …lives.** 40 hr (every third weekend & rotating holiday required) Job Summary: The RN Case Manager (CM) facilitates the coordination of care for those patients ... provides ongoing education to the physicians and nurses about levels of care. The RN Case manager, performs, consults, and collaborates in activities related to… more
- Brighton Health Plan Solutions, LLC (NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... review of services and care. * Provides referrals to Case management , Disease Management , Appeals...requirements. * Duties as assigned. Essential Qualifications * Current Registered Nurse ( RN ) with state… more
- Elevance Health (Waukesha, WI)
- …law._ The **LTSS Service Coordinator- RN Clinician** is responsible for overall management of member's case within the scope of licensure, develops, monitors, ... **LTSS Service Coordinator - RN Clinician ( RN Case ...chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any… more
- Humana (Juneau, AK)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Humana (Cheyenne, WY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse within the Clinical Access Grievance Team utilizes ... care management and utilization management skills...an impact** **Required Qualifications** + Associate's degree + Licensed Registered Nurse ( RN ) in the… more
- Select Medical (Tucson, AZ)
- …(Opening in January 2026)** _In Partnership with Select Medical_ **Position:** Director of Case Management **Location:** 355 North Wilmot Road, Tucson, AZ 85711 ... allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and… more
- Sutter Health (San Mateo, CA)
- …+ Other: Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + BLS-Basic Life Support Healthcare ... Care at Home - Bay **Position Overview:** An experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more
- Sutter Health (Santa Rosa, CA)
- …**EDUCATION:** Graduate of an accredited School of Nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California BLS-Basic Life Support Healthcare ... at Home - Outer Bay **Position Overview:** An experienced RN who is responsible for the overall management...the established plan of patient care and ensuring effective management of visit utilization and control of… more