• Oncology Prior Authorization Case Manager, Non-…

    University of Miami (Miami, FL)
    …of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent conducts ... initial, concurrent and retrospective chart reviews for clinical utilization and authorization. The Utilization Review...reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the… more
    University of Miami (12/20/25)
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  • RN Clinical Manager

    CenterWell (Liverpool, NY)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...(NY state requirement) + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (01/06/26)
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  • Assistant Nursing Director, Administration

    The County of Los Angeles (Los Angeles, CA)
    …clinical nursing. LICENSE(S) AND CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board or Registered ... in a state other than California must provide their Registered Nurse License Number from that state...Additional experience in clinical nursing. + Supervisory** experience in Utilization Review and/or Case Management . SPECIAL… more
    The County of Los Angeles (10/18/25)
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  • Registered Nurse - Community Living…

    Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
    …internal providers, and community partners to promote seamless, coordinated care. Apply utilization review criteria and evidence-based standards to ensure safe, ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. The EDRP Coordinator(s) can...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (11/05/25)
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  • Registered Nurse ( RN ), Main…

    Penn Medicine (Lancaster, PA)
    …NCLEX within 60 days of starting in their RN role. + A graduate registered nurse may only practice professional nursing under supervision and if the graduate ... that established outcomes are achieved through availability and appropriated utilization + of human, material and financial resources. +...their NCLEX within 60 days of starting in their RN role.A graduate registered nurse … more
    Penn Medicine (11/21/25)
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  • Respiratory Registered Nurse

    Quality Center for Rehabilitation and Healing (Lebanon, TN)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... . 5 days a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a highly motivated, flexible, organized, skilled respiratory therapist… more
    Quality Center for Rehabilitation and Healing (12/24/25)
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  • Clinical Denials Prevention & Appeals Specialist…

    Nuvance Health (Danbury, CT)
    …the time of review . If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with the care team in changing patient ... in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4… more
    Nuvance Health (12/25/25)
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  • RN - Care Manager - *0.5 FTE / Weekends…

    Providence (Olympia, WA)
    **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at risk ... Degree Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years Acute...Inpatient setting + IRR or annual competency testing in Utilization Review **Preferred Qualifications:** + Bachelor's Degree… more
    Providence (01/01/26)
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  • Care Manager RN *Weekends

    Providence (Spokane, WA)
    **Description** The Inpatient Registered Nurse ( RN ) Care Manager provides professional, comprehensive, patient centric care management services for at risk ... in Nursing degree/diploma upon hire + Upon hire: Washington Registered Nurse License + 2 years acute...Inpatient setting + IRR or annual competency testing in Utilization Review **Preferred Qualifications:** + Bachelor's Degree… more
    Providence (12/19/25)
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  • Registered Nurse ( RN )…

    Tenet Healthcare (Detroit, MI)
    Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate care along...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
    Tenet Healthcare (12/10/25)
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