• RN Utilization Review

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review - Case ...dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN more
    Tenet Healthcare (12/03/25)
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  • Utilization Review Case Mgr…

    UTMB Health (Webster, TX)
    Utilization Review Case Mgr -...**_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of ... observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
    UTMB Health (12/12/25)
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  • 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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  • PRN 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 (12/03/25)
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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 (12/31/25)
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  • Quality/ Utilization Review

    George C. Grape Community Hospital (Hamburg, IA)
    Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required;...nursing experience (acute care preferred). o Prior experience in utilization review , case management, quality… more
    George C. Grape Community Hospital (11/25/25)
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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 (12/05/25)
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  • Utilization Review Coordinator…

    Georgetown Behavioral Health Institute (Georgetown, TX)
    …Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable. + Knowledge, ... a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with… more
    Georgetown Behavioral Health Institute (12/30/25)
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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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  • Clinical Resource Management Nurse

    Hartford HealthCare (Manchester, CT)
    …Manchester Region serves a region of 300,000 people in 19 towns. POSITION SUMMARY: The Utilization Review Case Manager (UR CM) works in collaboration with ... Management* **Organization:** **Manchester Memorial Hospital* **Title:** *Clinical Resource Management Nurse ( RN ) - Case Coordination* **Location:**… more
    Hartford HealthCare (12/23/25)
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