• Premera Blue Cross (Mountlake Terrace, WA)
    …regulatory requirements, and ensures these requirements are accurately followed and Utilization Management (UM) decision determinations and timeliness standards ... work experience **(Required)** + Current State Licensure as a registered nurse where licensing is required by...Three (3) years of clinical experience ( **Required)** + Utilization Management experience (Preferred) + Experience working… more
    DirectEmployers Association (10/28/25)
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  • Premera Blue Cross (Mountlake Terrace, WA)
    …regulatory requirements, and ensures these requirements are accurately followed and Utilization Management (UM) decision determinations and timeliness standards ... work experience (REQUIRED) + Current State Licensure as a registered nurse (REQUIRED) + Three (3) years...+ Three (3) years of clinical experience (REQUIRED) + Utilization Management experience + Experience working in… more
    DirectEmployers Association (10/29/25)
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  • Stanford Health Care (Palo Alto, CA)
    …America) **A Brief Overview** The Oncology Research Nursing Professional (ORNP) -is a Registered Nurse ( RN ) who works collaboratively with Clinical Research ... in a related field **Licenses and Certifications** + California Registered Nurse ( RN ) + American...directions. + Understand and respond to multiple personalities and work/ management styles. + Resource management / utilization more
    DirectEmployers Association (10/24/25)
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  • BlueCross BlueShield of Tennessee (Chattanooga, TN)
    …this position\. + This job requires digital literacy assessment\. **Job Qualifications** _License_ + Registered Nurse \( RN \) with active license in the state ... sickle cell, brain injuries, oncology\-related needs\)\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine… more
    DirectEmployers Association (11/11/25)
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  • Alameda Health System (Oakland, CA)
    …in Nursing preferred. Required License/Certifications: CCRN - Critical Care Registered Nurse is desirable. Required Licenses/CertificationsTPM: ACLS, TNCC, ... MCH/OB Clinic (K6) + Full Time - Day + Management + $64.00- $96.00 + Req #:42878-31844 + FTE:1...department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California.… more
    DirectEmployers Association (09/22/25)
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  • Care Management , Care Coordinator

    Hackensack Meridian Health (Hackensack, NJ)
    …and serve as a leader of positive change. The **Care Management , Care Coordinator , Utilization Management ** is a member of the healthcare team and ... treatment. Accountable for a designated patient caseload; the Care Coordinator , Utilization Management plans effectively...**Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health… more
    Hackensack Meridian Health (11/07/25)
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  • Utilization Management

    Saint Francis Health System (Tulsa, OK)
    …field. Licensure, Registration and/or Certification: Valid multi-state or State of Oklahoma Registered Nurse License, or Clinical Social Worker (LCSW), or ... not all inclusive nor does it prohibit the assignment of additional duties. Utilization Management - Laureate Campus Location: Tulsa, Oklahoma 74136 **EOE… more
    Saint Francis Health System (11/14/25)
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  • RN Utilization Management

    Corewell Health (Grand Rapids, MI)
    …clinical nursing and or case management /managed care or related field Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... the state of Michigan. Manage all components of referral management , admission waiting list, insurance prior authorizations, continuous stay...within 7 years for those who start in this RN role on or after January 1, 2017 (Spectrum… more
    Corewell Health (11/04/25)
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  • OASIS Workflow Coordinator ( RN

    Hartford HealthCare (Bridgeport, CT)
    …Services / Home Care* **Organization:** **Hartford HealthCare at Home* **Title:** *OASIS Workflow Coordinator ( RN , Registered Nurse ) - HomeCare* ... settings. Degree from an accredited educational program leading to licensure as a Registered Nurse ( RN ), Physical Therapist (PT), Occupational Therapist… more
    Hartford HealthCare (11/04/25)
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  • Behavioral Health Intake and Utilization

    Charter Care Health Partners (Providence, RI)
    Summary: The Behavioral Health Intake and Utilization Review Coordinator is responsible for bed management , reviewing intake assessments, verifying clinical ... of experience in behavioral health, preferably in intake or utilization review roles. License: RI RN License...intake or utilization review roles. License: RI RN License required. Skills and Qualifications: + Strong clinical… more
    Charter Care Health Partners (10/21/25)
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