• Manager - Utilization Review

    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 ... Manager ) required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:** *MN-Minneapolis-Downtown Campus*… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... **Join Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff… more
    Beth Israel Lahey Health (10/30/25)
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  • Manager , Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse more
    Children's Mercy Kansas City (09/16/25)
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  • RN Case Manager - Utilization

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/228577/ rn -case- manager ... an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute… more
    Prime Healthcare (10/16/25)
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  • Registered Nurse - Case…

    Mayo Clinic (Rochester, MN)
    …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... to work well within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records, value based purchasing… more
    Mayo Clinic (10/02/25)
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  • Registered Nurse ( RN )

    Vighter Medical Group (Glendale, CO)
    Registered Nurse ( RN ) Glendale, CO Job...Community Care (OCC)in Glendale, Colorado.As aCase Manager / Utilization Review Nurse , you'll play a ... - Glendale, CO Position Type Full Time Education Level Registered Nurse ( RN ) Salary Range...You'll Do As a Case Manager / Utilization Review RN , you will:… more
    Vighter Medical Group (11/13/25)
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  • Registered Nurse

    Trinity Health (Langhorne, PA)
    …Mid-Atlantic, is seeking an experienced Registered Nurse to join our team in Utilization Review ! The UM Registered Nurse is responsible for the ... or Accredited Case Manager certification preferred. + Previous experience in Utilization review highly preferred. + Demonstrates ability to use problem… more
    Trinity Health (11/13/25)
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  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …Hospital-Plymouth** is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management** and ... plays a vital role in ensuring seamless, patient-centered care. ** RN - Utilization Review ** This...or other case management certification preferred or in progress ** Manager - Utilization Review &… more
    Beth Israel Lahey Health (10/30/25)
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  • UM Care Manager ( RN ) - Behavioral…

    UPMC (Pittsburgh, PA)
    …for authorization for behavioral health services. The Utilization Management (UM) Care Manager is responsible for utilization review of health plan ... Preference will be given to candidates with a Pennsylvania RN license. This role will review requests...Case management certification or approved clinical certification preferred + Registered Nurse ( RN ) *Current licensure… more
    UPMC (11/15/25)
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  • Utilization Manager

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
    Commonwealth Care Alliance (10/02/25)
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