• Enhanced Care Management Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse ( RN ); current and unrestrited California License. ... Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer: The expected pay… more
    LA Care Health Plan (07/16/25)
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  • Registered Nurse ( RN )…

    Rochester Regional Health (Rochester, NY)
    Job Title: Registered Nurse IDepartment: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time)Schedule: Monday ... Responsibilities include concurrent (as needed) and retrospective reviews. The Utilization Management Nurse will act...- Basic Life Support - American Heart Association (AHA), RN - Registered Nurse -… more
    Rochester Regional Health (08/02/25)
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  • Utilization Management Appeals…

    Emory Healthcare/Emory University (Atlanta, GA)
    …more **Description** We're seeking under the direction of the ** Utilization Management Appeals Professional, Registered Nurse ** is responsible for ... members of the patient care team, Medical Directors and Utilization Management leadership regarding trends in clinical...+ License - Must have a valid, active unencumbered Registered Nurse license or temporary permit approved… more
    Emory Healthcare/Emory University (08/08/25)
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  • Utilization Review Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to ... extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department...+ Licensure - Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
    Emory Healthcare/Emory University (08/08/25)
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  • Utilization Review Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …mentorship, _development,_ and leadership programs + And more **Description** The Clinical ** Utilization Review Nurse Preceptor (UR RN Preceptor)** will ... be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor...authorization, compliance and regulatory standards, and case management systems. + The UR RN Preceptor… more
    Emory Healthcare/Emory University (07/19/25)
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  • Per Diem Registered Nurse II/III…

    Ventura County (Ventura, CA)
    Per Diem Registered Nurse II/III - Utilization Management ... II + Six (6) months of experience in Utilization Management Per Diem RN III ... VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply  Per Diem Registered Nurse II/III - Utilization Management VCMC… more
    Ventura County (08/10/25)
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  • Supervisor, Care Review ( RN )

    Molina Healthcare (Milwaukee, WI)
    …and monitoring clinical and non-clinical team activities to facilitate integrated, proactive utilization management , ensuring compliance with regulatory and ... and Monitoring team responsible for prior authorizations, inpatient/outpatient medical necessity/ utilization review, and/or other utilization management more
    Molina Healthcare (07/27/25)
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  • Manager Care Management

    Catholic Health Initiatives (College Station, TX)
    …order to be considered for the Manager, Care Management postion.** + **Must be a Registered Nurse ( RN )** + **Must have have a minimum of Five (5) years ... Management a. Serves as a clinical resource for utilization management , compliance for the...and 3 years leadership experience Required License and Certification: Registered Nurse ( RN ) Required Minimum… more
    Catholic Health Initiatives (08/01/25)
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  • Registered Nurse

    Ascension Health (Baltimore, MD)
    …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... **Details** + **Department:** Utilization Management + **Schedule:** Part-time. Monday-Friday,...Registration: + Registered Nurse credentialed from the Maryland Board… more
    Ascension Health (05/17/25)
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  • Registered Nurse ( RN

    Penn Medicine (Lancaster, PA)
    …placement in position for incumbents who started after 07/01/2020. + A graduate registered nurse may only practice professional nursing under supervision and if ... the graduate registered nurse holds a current temporary practice... nurse is practicing. + All Clinical Nurse 1 RN 's will be required to… more
    Penn Medicine (08/07/25)
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