• Utilization Review Specialist…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... hospital clinical nursing experience, which includes three years in utilization review and/or case management...case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (11/02/25)
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  • Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    …discharge planning, and payer requirements. + Documents all utilization review activities in the hospital's case management software, including clinical ... submitting reconsiderations or coordinating peer-to-peer reviews. + Communicates effectively with utilization review coordinators, case managers, and… more
    Community Health Systems (11/15/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** ... case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review...+ Current license to practice as a Registered Nurse in the State of Utah,… more
    University of Utah Health (10/02/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management, or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...EHR and UR logs. + Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and… more
    BriteLife Recovery (11/03/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …our nurses set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** ... their passion for patient care. Apply today for our Registered Nurse Case Manager opportunity....care experience required. Minimum of two (2) years of utilization review / case management experience and… more
    HCA Healthcare (10/13/25)
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  • Registered Nurse Case Manager…

    Henry Ford Health System (Detroit, MI)
    …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
    Henry Ford Health System (10/09/25)
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  • UR Case Manager

    Eastern Connecticut Health Network (Manchester, CT)
    POSITION SUMMARY: The Utilization Review Case Manager (UR...or a related field. + Current licensure as an RN . EXPERIENCE: + 2 - 3 years' experience in ... in the acute-care setting. + Minimum of 1 year Utilization Review experience preferred via industry clinical...to payers for authorization of services provided and completes case review for claim reimbursement. + Reviews… more
    Eastern Connecticut Health Network (11/01/25)
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  • Clinical Reimbursement Case Management…

    Genesis Healthcare (Los Angeles, CA)
    …Five to seven years of clinical nursing experience is required. Prior experience in utilization review , case management or discharge planning is required. ... meaningful impact in the communities we serve. Responsibilities The Manager, Case Management is responsible for the clinical, administrative, and financial oversight… more
    Genesis Healthcare (11/06/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …for appropriate Level of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional ... SECTION I BASIC FUNCTION: The RN Case Manager has responsibility for...Case Manager include, but are not limited to, utilization review , case management, care… more
    Ellis Medicine (10/24/25)
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  • Oncology Prior Authorization Case Manager,…

    University of Miami (Miami, FL)
    …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
    University of Miami (10/18/25)
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