• Professional Care Manager

    UPMC (Hanover, PA)
    **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... weekend and holiday schedule.** **Purpose:** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization more
    UPMC (04/17/25)
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  • Lowe's Care Nurse - Case Manager

    Lowe's (Charlotte, NC)
    …years of experience in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in ... license in home State + CCM - Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse...or local law._ _Qualified applicants with arrest or conviction records will be considered for Employment_ _in accordance with_… more
    Lowe's (04/06/25)
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  • Utilization Review Nurse

    Adecco US, Inc. (Houston, TX)
    …**Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . **Review Medical Records :** Thoroughly evaluate patient medical ... . Preferred certifications include Certified Case Manager (CCM) or Certified Utilization Review Nurse (CURN). **Pay Details:** $85,000.00 to $110,000.00 per… more
    Adecco US, Inc. (05/01/25)
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  • 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 Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (03/27/25)
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  • RN / Nurse Utilization Review…

    Elevance Health (Woodbridge, VA)
    RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - Thursday, ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the most complex...experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination… more
    Elevance Health (05/03/25)
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  • Utilization Review Nurse

    Dignity Health (Gilbert, AZ)
    …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
    Dignity Health (04/04/25)
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  • Utilization Review Registered Nurse

    Community Health Systems (Naples, FL)
    **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical ... performance improvement of the UR KPI's. Ensures proper and accurate medical record documentation. **Essential Functions** + Reviews new admissions using 3rd party… more
    Community Health Systems (04/25/25)
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  • Case Manager (RN) - PRN Utilization

    Houston Methodist (The Woodlands, TX)
    …Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on ... initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from the physician… more
    Houston Methodist (02/08/25)
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  • Manager , Care Coordination (RN)…

    Stanford Health Care (Palo Alto, CA)
    …- 08 Hour (United States of America) Department: Oth Ancillary Svcs - Utilization Mgmt Commitment: Full-time (1.0 FTE) 8-hr. Days Schedule: 8-hr, Day Shift Strongly ... years of experience as an RN - 3+ years of experience in case management/ utilization review Why work at Stanford Medicine | Stanford Health Care (SHC)? - Recognized… more
    Stanford Health Care (02/22/25)
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  • Case Manager , RN - Utilization

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/204105/case- manager %2c-rn utilization ... perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.… more
    Prime Healthcare (04/17/25)
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