• Williamson Health (Nolensville, TN)
    …employer and a drug-free workplace. POSITION SUMMARY To perform the activities of Case Management and Utilization Management to facilitate the collaborative ... with the multidisciplinary health care team, focusing on resource management and discharge planning. Performs timely review ...currently licensed by the State of Tennessee as a Registered Nurse . Emergency Room and or Critical… more
    Appcast IO CPA (12/28/25)
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  • RN Utilization Review - Case…

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a ... Registered Nurse with us, you'll have the...for case management scope of services including: Utilization Management services supporting medical necessity and… more
    Tenet Healthcare (12/03/25)
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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 (12/14/25)
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  • Utilization Management

    Katmai (Fort Carson, CO)
    …Red Cross. + Three (3) years within the last four (4) years as a registered nurse in utilization management . + One (1) year of experience in UR/UM and ... **SUMMARY** Provide a comprehensive utilization review (UR) and utilization management...full, active, and unrestricted license to practice as a registered nurse . + Must be a graduate… more
    Katmai (11/26/25)
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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 (10/17/25)
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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 (10/17/25)
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  • SNF Utilization Management RN

    Humana (Jackson, MS)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (12/12/25)
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  • Care Manager RN - Utilization

    Highmark Health (Harrisburg, PA)
    …Highmark Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience **LICENSES AND… more
    Highmark Health (12/18/25)
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  • Utilization Management Manager,…

    UCLA Health (Los Angeles, CA)
    …+ experience in an HMO environment + Thorough knowledge of health care industry, utilization review , utilization management , and concurrent review ... at UCLA Health. As a Manager for Medicare Advantage Utilization Management , you'll provide direct management...following major functions: + Pre-service Authorizations/Denial Letters + Concurrent Review + Continuity of Care + Retro Claims +… more
    UCLA Health (12/30/25)
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  • Clinical Nurse III, Acute Inpatient…

    Alameda Health System (San Leandro, CA)
    Clinical Nurse III, Acute Inpatient Behavioral Health Utilization Management + San Leandro, CA + John George Psychiatric Hospital + JGP Care Coordination + ... EHR. 17. Maintains current knowledge of clinical practice and Utilization Management by literature review ,...Department). Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State ofCalifornia.\ Pay… more
    Alameda Health System (12/31/25)
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