• Sr Utilization Review

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the ... objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating… more
    Houston Methodist (08/26/25)
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  • Regional Utilization Review

    Trinity Health (Maywood, IL)
    …Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the multidisciplinary team ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
    Trinity Health (10/01/25)
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  • RN Utilization Review

    HonorHealth (AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe 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 (09/10/25)
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  • Utilization Management Specialist

    Vanderbilt University Medical Center (Tullahoma, TN)
    …status is ordered. The nurse conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary review ... difficulty. + Clinical Applications Systems (Novice): Possesses fundamental proficiency in utilization review systems, clinical support systems and business… more
    Vanderbilt University Medical Center (09/22/25)
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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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  • 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 ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • RN Utilization Review Remote

    HonorHealth (AZ)
    …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
    HonorHealth (09/26/25)
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  • Quality & Patient Safety Specialist

    Beth Israel Lahey Health (Cambridge, MA)
    …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by ... the key performance indicators and quality measures, the RN specialist also aims to foster a culture of safety...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review more
    Beth Israel Lahey Health (08/08/25)
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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 (09/18/25)
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  • Bed Control Specialist Registered…

    McLaren Health Care (Port Huron, MI)
    …solving and critical thinking skills. 4. Works with Case Management and Utilization Review regarding potential admissions. 5. Responsible to coordinate infection ... in Nursing (BSN) from an accredited program + Current State of Michigan Registered Nurse license + BLS and/or Canadian equivalent + Minimum two (2) years recent… more
    McLaren Health Care (09/26/25)
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