• Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
    LA Care Health Plan (07/08/25)
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  • RN Utilization Review

    HonorHealth (AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
    HonorHealth (06/11/25)
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  • Utilization Review Specialist

    Nuvance Health (Danbury, CT)
    …other duties as required. Education: ASSOCIATE'S LVL DGRE Required: 3 Years of Utilization Review experience(or a certification ACMA, MCG, Interqual) Required : ... (2nd week) ; rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and… more
    Nuvance Health (07/03/25)
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  • Registered Nurse Utilization

    LifePoint Health (Louisburg, NC)
    …a valid job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* ... Registered Nurse (RN) Utilization Review ...Registered Nurse (RN) Utilization Review Job Type: Full Time...of those we serve. Connect with our RN recruiting specialist . Do you need more time to complete an… more
    LifePoint Health (05/15/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    …knowledge of current trends and changes in healthcare delivery as it pertains to utilization review (eg, medical necessity, level of care) by participating in ... System Utilization Management SUM Specialist + Oakland,...Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet medical necessity… more
    Alameda Health System (07/19/25)
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  • Insurance Specialist -Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front end operations of the Case Management Department by ... Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. Clinical/Technical/Service**… more
    Mount Sinai Health System (07/23/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized ... reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison...Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent… more
    Commonwealth Care Alliance (05/21/25)
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  • Nurse Practitioner - Clinical…

    Cambridge Health Alliance (Cambridge, MA)
    …team leader in multi-disciplinary team discussion regarding treatment planning, treatment review , quality assurance and utilization review ... Nurse Practitioner - Clinical Specialist II (APRN), Psychiatry **Requisition Number:** CHAP-2270 **Cambridge Health Alliance (CHA)** , a well-respected,… more
    Cambridge Health Alliance (06/04/25)
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  • RN Utilization Management Openings - Apply…

    Amergis (Rancho Cordova, CA)
    Utilization Management. Apply today to learn more about the current opportunities! The Utilization Review Specialist is responsible for theassessment and ... + Current license for the state in which the nurse practicesif nursing licensure is required by contract +...Degree in Nursing or at least two years'experience in Utilization Review preferred + Certification in … more
    Amergis (07/03/25)
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  • Registered Nurse - Clinical Documentation…

    Cedars-Sinai (Los Angeles, CA)
    …Experience: A minimum of 5 years of experience in Acute Clinical Care, Utilization Review , Coding, or Case Management required Working knowledge of Joint ... for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8 Hour Days **Department** : CSRC CDI Services… more
    Cedars-Sinai (06/19/25)
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