• RN Coordinator- Utilization

    Henry Ford Health System (Troy, MI)
    …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State of Michigan License.… more
    Henry Ford Health System (08/07/25)
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  • Utilization Review Registered

    BJC HealthCare (St. Louis, MO)
    … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... team. This is a great opportunity for a local remote position. **Schedule** PRN (As needed) + Shifts will...in St. Louis. + Have both Missouri and Illinois RN licenses. + If candidate only has one … more
    BJC HealthCare (07/12/25)
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  • Registered Nurse ( RN ) Case…

    Ochsner Health (New Orleans, LA)
    …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
    Ochsner Health (07/30/25)
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  • Case Manager - Registered Nurse

    CVS Health (Austin, TX)
    …it all with heart, each and every day. **Position Summary** This Case Manager - Registered Nurse ( RN ) position is with Aetna's National Medical Excellence ... to apply, however, preference is for candidates in compact Registered Nurse ( RN ) states. This...is a blended role doing both Case Management and Utilization Management. The RN Case Manager is… more
    CVS Health (08/08/25)
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  • RN - Utilization Review (S)

    SSM Health (MO)
    …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... **It's more than a career, it's a calling.** MO- REMOTE **Worker Type:** Regular **Job Summary:** Ensure payors...Registered Nurse ( RN ) - Missouri Division of Professional… more
    SSM Health (08/12/25)
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  • Case Manager Registered Nurse

    CVS Health (Austin, TX)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (08/10/25)
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  • Utilization Review Specialist…

    Emory Healthcare/Emory University (Atlanta, GA)
    …**Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to assist ... experience or a minimum of two years of previous utilization review experience. + Licensure - Must...+ Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
    Emory Healthcare/Emory University (08/09/25)
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  • Registered Nurse I - Medical…

    Saint Francis Health System (Tulsa, OK)
    …from ER, ICU, and CTU units. + All private rooms Job Summary: The Registered Nurse I assesses, plans, implements and evaluates nursing care, utilizing the ... therefrom. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License. Work Experience: 0 - 6 months related… more
    Saint Francis Health System (06/07/25)
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  • Per Diem RN Case Manager,…

    Children's Hospital Boston (Boston, MA)
    Utilization Management) preferred. Licensure/ Certifications: + Current Massachusetts license as a Registered Nurse ( RN ) + A certification as a Certified ... 80451BRJob Posting Title:Per Diem RN Case Manager, Utilization Management/ReviewDepartment:Patient Services-Patient Care… more
    Children's Hospital Boston (06/16/25)
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  • RN - Utilization Review

    Ascension Health (Milwaukee, WI)
    …initiatives. + Develop systems and process for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... authorization codes for all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer… more
    Ascension Health (08/08/25)
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