• SNF Utilization Management RN - Compact Rqd

    Humana (Jackson, MS)
    …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
    Humana (12/12/25)
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  • Clinical Product Consultant - Utilization

    Waystar (Atlanta, GA)
    …end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor in ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of Utilization more
    Waystar (11/21/25)
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  • RN - Quality Assurance/ Utilization Review…

    Emanate Health (Covina, CA)
    …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity ... or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and level of care reviews for requested… more
    Emanate Health (12/06/25)
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  • RN Utilization Mgmt I

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shifts Covenant Health Overview: Covenant Health is the region's ... be named a Forbes "Best Employer" seven times. Position Summary: The RN Utilization Management I will perform utilization management functions to include medical… more
    Covenant Health Inc. (12/18/25)
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  • Nurse Manager - Utilization Review

    Huron Consulting Group (Chicago, IL)
    …expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, and directing implementation of ... the Utilization Review Plan and the overall operation of the Utilization Management Department in accordance with federal, state and local guidelines, regulatory… more
    Huron Consulting Group (11/27/25)
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  • Utilization Review Analyst - Registered…

    Beth Israel Lahey Health (Burlington, MA)
    …weekends. This position is on-site at Lahey Hospital and Medical Center. The Utilization Analyst works with physicians, the payers and inpatient case management team ... medical necessity of the hospital care. Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case… more
    Beth Israel Lahey Health (10/30/25)
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  • RN - Utilization Review - *EVENINGS

    Providence (Olympia, WA)
    **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management ... we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years - Nursing **Preferred Qualifications:** + Bachelor's… more
    Providence (12/18/25)
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  • RN Utilization Review/Discharge Planning…

    Sanford Health (Rapid City, SD)
    …patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients ... and standards of nursing practice as outlined in the Nurse Practice Act and Administrative Rules in state of...is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Incumbent must obtain and… more
    Sanford Health (12/24/25)
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  • Rapid Response / Registered Nurse / RN

    Emory Healthcare/Emory University (Atlanta, GA)
    …ready to join a team that's redefining quality nursing care. The (RUN) Resource Utilization Nurse is primarily responsible for supporting the critical care units ... _development,_ and leadership programs **Description** **Rapid Response Unit Charge Nurse / RN** 7p-7:30a / Full Time / 36...direct patient care assignment as needed while the primary nurse is off unit with another patient, and assisting… more
    Emory Healthcare/Emory University (11/12/25)
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  • Registered Nurse (RN) - Utilization

    Dartmouth Health (Lebanon, NH)
    …communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote:Fully Remote * Area of ... Interest:Nursing * Pay Range:$79,747.20/Yr. - $127,587.20/Yr. (Based on 40 hours per week, otherwise pro rata) * FTE/Hours per pay period:.01 hrs/per week (per diem/temp) * Shift:Rotating * Job ID:35880 Dartmouth Health offers a total compensation package that… more
    Dartmouth Health (12/04/25)
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