• Quality Management Clinical Nurse

    UCLA Health (Los Angeles, CA)
    Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards ... involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient care and safety. In… more
    UCLA Health (07/14/25)
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  • Operating Room Clinical Nurse Coordinator

    HCA Healthcare (Richmond, VA)
    …we encourage you to apply for our Operating Room Quality Clinical Nurse Coordinator opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a Operating Room Quality Clinical Nurse Coordinator you want in your current role? We invest in what… more
    HCA Healthcare (06/21/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team....Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the largest… more
    The County of Los Angeles (06/28/25)
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  • Utilization Review Nurse

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of care using...resolve progression-of-care barriers through appropriate administrative and medical channels. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS** + Participates in quality more
    Houston Methodist (05/20/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (Newark, DE)
    **Responsibilities:** Under the direction of a supervisor, the Utilization Management Review Nurse evaluates medical necessity for inpatient and outpatient ... based on clinical criteria. Using professional judgment, the Utilization Management Review Nurse assesses the appropriateness of services, identifies care… more
    AmeriHealth Caritas (07/02/25)
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  • Hybrid Clinical Review Nurse

    Actalent (Sunrise, FL)
    Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to ... in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ensuring smooth… more
    Actalent (07/22/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Little Rock, AR)
    …offering competitive benefits including a fresh perspective on workplace flexibility. Clinical Review Nurse - Concurrent Review & Outpatient Services ... overall health and appropriate level of care + Reviews quality and continuity of care by reviewing acuity level,...care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
    Centene Corporation (07/18/25)
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  • Utilization Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ensure ... staff to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, utilizing… more
    Actalent (07/16/25)
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  • Registered Nurse - Authorization…

    Staffing Solutions Organization (Augusta, ME)
    …which is a reflection of our clients and the people they serve. **Registered Nurse - Authorization Review Unit - MaineCare in Augusta, ME** **Position Duties:** ... by the PA supervisor, utilizing PA software tools; + Review and authorize provider requests for the following services...work queues and complete assigned tasks; + Conduct regular quality assurance reviews of decided PAs; + Collaborate with… more
    Staffing Solutions Organization (06/21/25)
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