• Behavioral Health Care Advisor- Substance Use…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Minnesota Position Title: Behavioral Health Care Advisor- Substance Use Disorders Location: Remote Career Area: Health Services About Blue Cross and Blue Shield of ... events to engage with members. Required Skills and Experience * Registered Nurse with Psychiatric experience or Behavioral Health Professional that is Clinician… more
    Blue Cross and Blue Shield of Minnesota (11/05/25)
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  • RN Clinical Denials Appeals Specialist

    CommonSpirit Health (Centennial, CO)
    …as a Registered Nurse . 3 years with progressive experience in utilization review , preferred. Prior experience writing clinical denial appeal letters ... indicated through research and coordination of completion of medical records and utilization review processes. Identifies areas for documentation and/or process… more
    CommonSpirit Health (11/15/25)
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  • Advanced Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Reno, NV)
    …aligned care team). The Advanced MSA coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization ... of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical… more
    Veterans Affairs, Veterans Health Administration (11/22/25)
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  • Case Manager, RN or Licensed Behavioral Health…

    Excellus BlueCross BlueShield (Rochester, NY)
    …for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. ... consistent and quality health care services. Examples may include: Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory… more
    Excellus BlueCross BlueShield (11/20/25)
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  • RN Referral Management Coordinator (Virtual)…

    Henry Ford Health System (Troy, MI)
    …Full Time Benefit Eligible Schedule: Monday through Friday, 8:00AM to 4:30PM, Remote GENERAL SUMMARY: Unit Description: Health Alliance Plan (HAP) is looking to ... Nurses (5 and counting), and Administrative Professionals (3) that review medical necessity and medical criteria for all prior...the time of the denial and distributes to the Utilization Management Services staff for processing. + Reports on… more
    Henry Ford Health System (11/18/25)
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  • Director, Organ Optimization

    LifeCenter Northwest (Bellevue, WA)
    …donor management protocols aimed at optimizing organ function and increasing organ utilization . + Routinely reviews performance metrics and recommends changes in ... plans focused on optimizing organ function and increasing organ utilization . + Serves as a change agent for the...as well as other business environments, which may include remote work in a home office setting, if applicable… more
    LifeCenter Northwest (09/20/25)
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  • RN Plan Case Manager Atlanta

    PruittHealth (Atlanta, GA)
    …years industry experience in a managed care setting focused on experience in utilization review /case management and at least two years case management, home ... patient based on a thorough history and clinical record review , including the attending physician's plan, the recommendations of...Ability to work independently and be self-motivated in a remote environment * Manage assigned case load as business… more
    PruittHealth (11/19/25)
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  • LPN Case Manager

    Ochsner Health (Slidell, LA)
    …of hospital-based experience. **Preferred** - Experience in utilization review . **Certifications** **Required** - Current licensed practical nurse (LPN) ... **Job Description** **Education** **Required** - Graduate of an accredited licensed practical nurse (LPN) program. **Work Experience** **Required** - 3 years… more
    Ochsner Health (10/23/25)
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  • Senior Solution Architect, Nursing - Build,…

    Oracle (Harrisburg, PA)
    …(ECD) alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal ... a prominent academic medical center in the Midwest. This remote role will act as the primary subject matter...offer ongoing consultation to support user proficiency and system utilization . Monitor project outcomes, track key metrics, and report… more
    Oracle (11/25/25)
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  • Capital Sales Representative-Interventional…

    Teleflex (Boston, MA)
    …territory. The incumbent is responsible for the growth of overall product utilization within their accounts; including, but not limited to, selling the designated ... gain new business. * Facilitate sales growth by conducting physician, nurse , and technologist training and account in-servicing of Interventional Capital products.… more
    Teleflex (11/19/25)
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