• Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …their scope of practice and according to state law. **Required** + One year ** Utilization Review or Case Management** experience. **Corporate Overview:** The ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required**… more
    University of Utah Health (01/06/26)
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  • RN Utilization Manager - Medicine,…

    UNC Health Care (Chapel Hill, NC)
    …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
    UNC Health Care (01/14/26)
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  • RN Utilization Manager - Care…

    UNC Health Care (Smithfield, NC)
    …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...of patient data and treatments. Communicates daily with the Case Manager to manage level of care… more
    UNC Health Care (12/23/25)
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  • Utilization Review Coordinator

    Behavioral Center of Michigan (Warren, MI)
    …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
    Behavioral Center of Michigan (12/21/25)
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  • Utilization Review Coordinator

    Community Health Systems (Franklin, TN)
    …authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist. + Monitors and updates case management software ... **Job Summary** The Utilization Review Coordinator ensures efficient and...with hospital, corporate, and payer requirements. Documents outcomes in case management systems. + Reviews and closes out cases… more
    Community Health Systems (11/22/25)
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  • Utilization Manager (RN)

    UNC Health Care (Hendersonville, NC)
    …the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge ... in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities: + Uses approved...patient data and treatments. Communicates daily with the Care Manager to manage level of care transitions & appropriate… more
    UNC Health Care (12/24/25)
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  • UM Coordinator - Utilization Review…

    Hackensack Meridian Health (Belle Mead, NJ)
    … of resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and ... the care for a designated patient caseload. Collaborates with the attending LIP, Clinical Case Manager , nurse, and other members of the treatment team, ACCESS… more
    Hackensack Meridian Health (01/10/26)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …Preferred Masters in Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years in Case Management or + Required 3 ... of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions… more
    BayCare Health System (01/09/26)
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  • RN Utilization Review

    Sedgwick (Columbus, OH)
    …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review **PRIMARY PURPOSE** : To utilize evidence based tools to ... and claims examiners regarding pharmacy issues. + Performs drug utilization reviews through the pharmacy benefit manager ...of direct clinical care **OR** two (2) years of case management/ utilization management. **Skills & Knowledge** +… more
    Sedgwick (01/16/26)
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  • Behavioral Health Care Manager I,…

    Elevance Health (CA)
    **Behavioral Health Care Manager I, Utilization Management** **Work Hours M-F 8am-5pm PST** **Work Location: Virtual, California** This role enables associates ... an accommodation is granted as required by law. The **Behavioral Health Care Manager I, Utilization Management** is responsible for managing psychiatric and… more
    Elevance Health (01/08/26)
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