• RN Pre Certification Case Manager

    Penn Medicine (Philadelphia, PA)
    …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + ... * And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best care… more
    Penn Medicine (08/07/25)
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  • RN Admissions Case Manager - OLGMC…

    Ochsner Health (Lafayette, LA)
    …license in state of practice. Preferred - Commission for Case Manager (CCM), Certified Professional Utilization Review (CPUR), Certified Professional ... in the delivery of patient care. Preferred - Experience in case management or utilization review . **Certifications** Required - Current Registered Nurse… more
    Ochsner Health (08/14/25)
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  • RN Supervisor Case Management - Full Time…

    Mohawk Valley Health System (Utica, NY)
    …to our diverse member population. Provides direct oversight of the case manager 's daily operations of utilization review practice, processes and ... Management - SNH is responsible for the oversight of the case management staff's authorization/coordination/ utilization and provision of member services. Duties… more
    Mohawk Valley Health System (07/09/25)
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  • Oncology Prior Authorization Case

    University of Miami (Miami, FL)
    …System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. ... and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team… more
    University of Miami (09/25/25)
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  • Oncology Prior Authorization Case

    University of Miami (Miami, FL)
    …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Utilization Review Case Manager ... of Miami is currently seeking a Prior Authorization Nurse Case Manager . The incumbent purose is to...forth by the payer or clinical guidelines + Accurate review of coverage benefits and payer policy limitations to… more
    University of Miami (08/23/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for ...inpatient experience in a hospital environment preferred. + Previous case management, utilization review , and… more
    Ellis Medicine (09/11/25)
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  • Clinical Resource Manager

    Nuvance Health (Sharon, CT)
    …health to the patient. Responsibilities for this full time RN Case Manager position includes include utilization review , discharge planning and care ... license, Bachelors Degree in Nursing or related field, a minimum of 1 year Case Management experience in an acute care setting. CCM, PRI and Screen certifications… more
    Nuvance Health (07/23/25)
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  • RN Case Manager - Travel $3042/Wk

    Amergis (French Camp, CA)
    …hours per week RNs will be doing denials, discharge planning, and utilization review **Needs Case Manager Experience in ACUTE setting** Current Discharge ... Planning experience Denials experience Utilization review experience InterQual experience Working with...experience with PERFORMANT or CDCR denials DESIRED The RN Case Manager is responsible for coordinatingcontinuum of… more
    Amergis (08/30/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …track, review , and analyze data relating to continuous quality improvement. The Utilization Case Manager will work on a Full-Timebasis supporting ... issues. To support the mission of Helio Health, theUtilization Case Manager will enhance the program's efforts...Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care,… more
    Helio Health Inc. (09/30/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
    Minnesota Visiting Nurse Agency (09/30/25)
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