• System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As ... The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (04/26/25)
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  • Interim Director, Care Management

    Trinity Health (Des Moines, IA)
    …Type:** Full time **Shift:** **Description:** **_Are you an experienced Director of Care Management & Utilization Review looking for an interim assignment? ... specialty, departmental and organizational goals. **MINIMUM QUALIFICATIONS:** + Current Iowa License Registered Nurse or Social Worker + Master's degree in… more
    Trinity Health (05/01/25)
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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 ... and Barnstable counties. Our Nutrition Services Team consists of registered and licensed dietitians who provide expert nutritional interventions...and Serve Your Community!** **In your role as a Utilization Review & Denials Management more
    Beth Israel Lahey Health (04/29/25)
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  • Utilization Management Review

    AmeriHealth Caritas (Dover, DE)
    …required; Bachelor's Degree in Nursing (BSN) preferred. + An active OH or compact state Registered Nurse ( RN ) license in good standing is required. + 3+ ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services,… more
    AmeriHealth Caritas (04/29/25)
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  • RN / Nurse Utilization

    Elevance Health (Woodbridge, VA)
    RN Utilization Review Nurse (Washington DC...is located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review ... scope of licensure the District of Columbia is required. **Preferred Qualifications:** + Utilization Management / Review in managed care strongly preferred. +… more
    Elevance Health (05/03/25)
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  • Per Diem RN Case Manager,…

    Children's Hospital Boston (Boston, MA)
    79378BRJob Posting Title:Per Diem RN Case Manager, Utilization Management /ReviewDepartment:Patient Services-Patient Care ... + Experience as a Case Manager (Discharge Planning and or Utilization Management ) preferred. Office/Site Location:BostonRegular, Temporary, Per Diem:Per Diem… more
    Children's Hospital Boston (05/01/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in...+ Do you have experience with Utilization Review ? + Do you have an Active Registered more
    US Tech Solutions (04/18/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... . 1+ years of inpatient hospital experience . Registered Nurse in state of residence ....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE… more
    US Tech Solutions (04/18/25)
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  • Utilization Review Nurse

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse ( RN ) Location:...Handbook) + 401(k) Plan Minimum Requirements Registered Nurse ( RN ) Utilization Management ... and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse ( RN...care clinical setting and 12 months consecutive experience in utilization management , utilization review more
    Matrix Providers (04/29/25)
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  • SNF Utilization Management RN

    Humana (Raleigh, NC)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied… more
    Humana (05/03/25)
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