• Director Case Management

    Brockton Hospital (Brockton, MA)
    …delays through problem resolution and follow-up. Monitors on-site case managers and utilization review staff to ensure compliance with Signature Healthcare ... management experience Proven experience in coordinating discharge planning and utilization review experience required. Prior management experience required.… more
    Brockton Hospital (12/12/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
    Corewell Health (12/29/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
    Corewell Health (10/23/25)
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  • Penn Medicine Physician Advisor

    Penn Medicine (Philadelphia, PA)
    …the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. The Physician Advisor ... changes in payer rules including CMS rules as it pertains to utilization review * Recommend and request additional and more complete medical record documentation… more
    Penn Medicine (12/06/25)
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  • Medical Records Review Nurse / Medical…

    System One (Baltimore, MD)
    …experience (acute care preferred) + Previous case management, discharge planning, or utilization review experience + EMR navigation experience + Basic Excel ... Job Title: Clinical Medical Review Nurse Location: Baltimore, MD 21224 Type: Contract,...to providers for record retrieval, as needed. Clinical Medical Review Nurse / Medical Records Abstraction Specialist Schedule: 8-hour… more
    System One (01/06/26)
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  • Senior Medical Director Appeals, National Physical…

    Centene Corporation (Jefferson City, MO)
    …appeals and collaborate with key stakeholders for IRE challenges + Perform medical review activities pertaining to utilization review , quality assurance, and ... physician education with respect to clinical issues and policies. + Identify utilization review studies and evaluate adverse trends in utilization of medical… more
    Centene Corporation (01/06/26)
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  • Clinical Resource Management Nurse (RN) - Case…

    Hartford HealthCare (Manchester, CT)
    …Region serves a region of 300,000 people in 19 towns. POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with the physician ... of care in the acute-care setting. * Minimum of 1 year Utilization Review experience preferred via industry clinical standards, ie, InterQual, Milliman Care… more
    Hartford HealthCare (12/23/25)
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  • Case Manager II - Transition Planning - Sharp…

    Sharp HealthCare (San Diego, CA)
    …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... nursing experience or case management experience. + 3 Years case management, utilization review , care coordination experience. + California Registered Nurse (RN)… more
    Sharp HealthCare (12/18/25)
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  • Senior Strategic Sourcing Lead

    UPMC (Pittsburgh, PA)
    …complex clinical specialty committees focused on product introductions, value analysis and utilization review consistent with UPMC policies and procedures. + ... for various clinical and non-clinical disciplines across UPMC, including regular utilization review , spend analysis, product introductions and trials. +… more
    UPMC (01/06/26)
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  • Lead, Strategic Sourcing

    UPMC (Pittsburgh, PA)
    …for various clinical and non-clinical disciplines across UPMC, including regular utilization review , spend analysis, product introductions and trials. + ... Supports clinical specialty committees focused on product introductions, value analysis and utilization review consistent with UPMC policies and procedures. +… more
    UPMC (12/18/25)
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