• Primary Care Physician Lead

    CenterWell (Morrow, GA)
    …intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: + Maintaining ... for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member per Month (PMPM)… more
    CenterWell (01/06/26)
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  • Home Care Supervisor, RN

    BayCare Health System (Sarasota, FL)
    …bodies within the area of responsibility. + Ensure quality assurance program and utilization review is followed in accordance with Home Care protocol. + Oversees and ... Manager on initial Plan of Care review with a focus on quality, utilization and individual patient care goals. + Knowledge of regulatory standards appropriate to… more
    BayCare Health System (01/06/26)
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  • Care Management Tech

    Tenet Healthcare (Detroit, MI)
    …appropriate provider. Performs input into various databases as appropriate for utilization management, LOS management and Denial Management activities. Audits data ... coverage and general concerns regarding policies and procedures. Maintains necessary utilization review files for all patients in the hospital. Validates discharge… more
    Tenet Healthcare (01/04/26)
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  • RN Neuro Spine

    Corewell Health (Grand Rapids, MI)
    …recovery. Additional unique skills that those hired to 3H will learn include utilization of the NIHSS Stroke Scale. About Blodgett Hospital Set within a quiet, ... practice and research, quality of practice, professional practice evaluation, resource utilization and environmental health. Strives to achieve optimal outcomes. How… more
    Corewell Health (01/03/26)
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  • Respiratory Therapy

    Trevecca Center for Rehabilitation and Healing (Nashville, TN)
    …the administrator in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget ... Maintaining close communications within the facility with the director of nursing, nurse managers, and admissions coordinator to assist in development of the… more
    Trevecca Center for Rehabilitation and Healing (01/03/26)
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  • Case Manager - RN

    Calvary Hospital (Bronx, NY)
    …Transit Check. + Free On-Site Parking Requirements Participates in the Utilization Review, Discharge Planning, Risk Management, and Quality Assessment and ... prior to beginning employment at Calvary Hospital. Requirements + Registered professional nurse , current unencumbered NYS licensure. + Five (5) or more years… more
    Calvary Hospital (01/03/26)
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  • Analyst, Claims

    East Boston Neighborhood Health Center (Revere, MA)
    …to the health and well-being of our patients and communities. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part ... review referrals and claims-related data in an effort to provide utilization reports to other departments. Insurance Department: * Must maintain up-to-date… more
    East Boston Neighborhood Health Center (01/01/26)
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  • RN Case Manager - Barnes-Jewish Hospital

    BJC HealthCare (St. Louis, MO)
    …Care Services. The CM Service is comprised of three departments: Case Management, Utilization Management, and Social Work. Through the Triad Model of Care Delivery, ... Service employs registered nurses, social workers, a license practical nurse , a customer service representative, and administrative assistants. **Preferred… more
    BJC HealthCare (01/01/26)
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  • Case Manager Care Continuity Services RN - Care…

    Truman Medical Centers (Kansas City, MO)
    …We are seeking a dedicated and detail-oriented Case Manager (CM)-a registered nurse committed to optimizing both patient outcomes and healthcare resources. In this ... both spoken and written **Preferred Qualifications:** + RN experience in hospital utilization review, utilization management, or case management **Why Join Us?**… more
    Truman Medical Centers (01/01/26)
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  • Clinical Care Coordinator

    Kaleida Health (Williamsville, NY)
    …paths are addressed and met. Serve as liaison to ancillary and utilization review services, serve as communication link between health team members. Manage ... Bachelors degree in Nursing. Current NYS Registration as a Professional Nurse . Certified Case Manager (CCM) preferred. **Experience** **At least 3 years… more
    Kaleida Health (12/31/25)
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