- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry, observation progression...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Abbott (Plymouth, MN)
- …+ Manage field device demo needs, tracking sales & patient resource utilization , and working with communications manager to manage promotional collateral. ... people in more than 160 countries. **Senior Product Marketing Manager - TAVR** **Working at Abbott** At Abbott, you...**WHAT YOU'LL WORK ON** + The Senior Product Marketing Manager - TAVR, will lead downstream marketing efforts while… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to… more
- Access Dubuque (Dubuque, IA)
- …Management Cottingham & Butler/ SISCO Risk Management and Accreditation Program Manager UnityPoint Health Finley Hospital Utilization Management Nurse Cottingham ... Utilization Management CNA **Cottingham & Butler/ SISCO** 1...4965537008 Posted On 10/24/2025 Refreshed On 11/24/2025 **Job Overview** ** Utilization Management Assistant** **Location** : Onsite in Dubuque, IA.… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and appeals ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, assists… more
- University of Utah Health (Salt Lake City, UT)
- …advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated ... or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity criteria for… more
- Dignity Health (Gilbert, AZ)
- …of nursing experience + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification + Utilization Review experience **Where You'll ... of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use… more
- Avera (Sioux Falls, SD)
- …levels of care, to promote the best possible patient outcome. The case manager facilitates efficient utilization of resources and identifies patient care needs ... throughout the continuum of care. **What you will do** + Acts as liaison with hospitals and other health care service to provide treatment advice and lobby on behalf of the patients to various payor sources. + Identifies community resources which can provide… more
- Providence (Mission Hills, CA)
- **Description** **RN Utilization Review - Remote. This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and concurrent ... utilization reviews for our LA ministries. Conduct clinical reviews...UR environment or working as an acute hospital case manager . **Preferred Qualifications:** + Bachelor's Degree in Nursing. +… more
- Cleveland Clinic (Cleveland, OH)
- …of the most respected healthcare organizations in the world. As a Utilization Management Specialist, you will perform UM activities, such as admission, concurrent, ... requirements.** A caregiver who excels in this role will: + Recommend resource utilization . + Prioritizes and organizes work to meet changing priorities. + Utilizes… more