• Utilization Manager Registered

    Commonwealth Care Alliance (Boston, MA)
    …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
    Commonwealth Care Alliance (10/02/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43 - $141,888.74 Annually Location Ventura and Santa Paula, CA Job Type Full-Time Regular… more
    Ventura County (09/21/25)
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  • Registered Nurse RN ED…

    AdventHealth (Tampa, FL)
    …as heart failure, cancer and other diseases. **The role you'll contribute:** The Utilization Management nurse uses clinical expertise to review patient records ... in emergency department setting. Utilize critical thinking and expertise in utilization review regarding medical necessity, patient status, level of care, and… more
    AdventHealth (11/07/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Miami, FL)
    …initiatives as well as customer service programs. The Utilization Management/Float Registered Nurse ( RN ) is responsible for providing competent, ... Miami VA medical Center is looking for recruit for Registered Nurse - Utilization Management...the Associate Director of Patient Care Services (ADPCS). The Utilization Management/Float ( RN ) follows procedures per established… more
    Veterans Affairs, Veterans Health Administration (11/14/25)
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  • Registered Nurse ( RN ) - Med…

    Bon Secours Mercy Health (Suffolk, VA)
    …Advanced Cardiac Life Support acceptable in lieu of BLS) Medical-Surgical Nursing Certification RN -BC ( Registered Nurse - Board Certified) (preferred) CCRN ... ( RN ) - Med-Surg -Harbour View Medical Center_** **Job Summary:** The Med-Surg Registered Nurse ( RN ) position is responsible for delivering exceptional… more
    Bon Secours Mercy Health (11/14/25)
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  • Registered Nurse Utilization

    McLaren Health Care (Port Huron, MI)
    …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per...Assigned:** 1. Performs a variety of concurrent and retrospective utilization management-related reviews and functions to ensure that appropriate… more
    McLaren Health Care (11/12/25)
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  • Utilization Review Registered

    Actalent (Atlanta, GA)
    Utilization Review - Registered Nurse Job...and Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse ( RN ) with a valid ... GA or Compact. + 1+ years of experience in Utilization Management (UM). + 1+ years of experience in...+ Experience with MCG or Interqual is preferred. + Utilization review experience is a plus. Job Type &… more
    Actalent (11/15/25)
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  • Registered Nurse

    Trinity Health (Langhorne, PA)
    …Center, a member of Trinity Health Mid-Atlantic, is seeking an experienced Registered Nurse to join our team in Utilization Review! The UM Registered ... and acceptable clinical outcomes, through integration and implementation of utilization management. **Minimum Requirements:** + Bachelor's degree in nursing… more
    Trinity Health (11/13/25)
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  • Clinical Registered Nurse

    Cognizant (Annapolis, MD)
    …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification,… more
    Cognizant (11/15/25)
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  • Registered Nurse ( RN )…

    Bon Secours Mercy Health (Portsmouth, VA)
    …sign on bonus **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse ( RN ) functions as a care provider of a ... safety and privacy of all persons. + Understanding and utilization of office and clinical technologies. + Ability to...where associates want to work and help communities thrive. ** Registered Nurse ( RN ) -** Psychiatric… more
    Bon Secours Mercy Health (11/11/25)
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