• Northern Nevada Medical Center (Sparks, NV)
    …Department to determine the appropriate patient status. Collaborates with physician , physician extender, nurse, case manager/ utilization review and HIM ... in medical records, and utilizes strong communication skills with physician , physician extender, case manager, utilization review , nurse or other… more
    Appcast IO CPA (10/13/25)
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  • Carle Health (Champaign, IL)
    …patient care outcomes. The incumbent will have a deep understanding of utilization review and case management principles, case management best practices, ... experience 2+ years Responsibilities Maintain current knowledge of case management and utilization review trends including the entire continuum of care within… more
    Appcast IO CPA (12/31/25)
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  • Carle Health (Normal, IL)
    … issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of care document ... RN >2yrs Responsibilities Act as a liaison working with patient/family and physician to determine next level of care and manage LOS.Coordinates the transition… more
    Appcast IO CPA (12/30/25)
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  • Novo Nordisk Inc. (Atlanta, GA)
    …and unique insights Leverages superior understanding of complexities within the targeted physician customer base in order to maximize performance Applies high level ... appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved… more
    HireLifeScience (12/19/25)
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  • Physician Utilization Review

    Hackensack Meridian Health (Hackensack, NJ)
    **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
    Hackensack Meridian Health (11/12/25)
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  • Utilization Review Specialist

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry ... this position is able to cover a multitude of utilization review functions through point of entry,...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… more
    Houston Methodist (11/02/25)
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  • Utilization Review Specialist

    Medical Center Hospital (Odessa, TX)
    + Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the ... hospital Utilization Review Program and makes appropriate referrals to designated Physician Advisors. + Qualifications: A. Education: Holds a current Texas… more
    Medical Center Hospital (10/18/25)
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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: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (12/20/25)
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  • Utilization Management Specialist

    Penn Medicine (Lancaster, PA)
    …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible...accommodation to perform the following duties:** + Complete chart review and communicate patient status medical needs with insurance… more
    Penn Medicine (12/24/25)
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  • Utilization Management Specialist II

    AnMed Health (Anderson, SC)
    …necessity review , continued stay/concurrent review , retrospective review , bed status management, resource utilization management, regulatory compliance, ... assigned utilization management functions daily: initial, concurrent and retrospective review of the medical record with speed and accuracy for all required… more
    AnMed Health (11/13/25)
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