• Senior Director, Utilization

    Centene Corporation (Jefferson City, MO)
    …+ Leads utilization management policies and procedures within the utilization management team to ensure compliance with corporate, state, and ... + Expert knowledge of industry regulations, policies, and standards preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or… more
    Centene Corporation (06/26/25)
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  • RN Utilization Review…

    Ascension Health (Jacksonville, FL)
    …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... **Details** + **Department:** Utilization Management + **Schedule:** Part Time;...Registration: + Licensed Registered Nurse obtained prior to hire date… more
    Ascension Health (06/18/25)
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  • RN Registered Nurse

    Ascension Health (Tulsa, OK)
    …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management...Registration: + Registered Nurse credentialed from the Oklahoma Board… more
    Ascension Health (06/14/25)
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  • RN Registered Nurse

    Ascension Health (Wichita, KS)
    …coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification / ... offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review. +...Registration: + Licensed Registered Nurse credentialed from the Kansas Board… more
    Ascension Health (06/18/25)
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  • Utilization Review Registered

    MaineGeneral Health (Augusta, ME)
    …MaineGeneral Health is offering an exciting opportunity for an experienced Utilization Review Registered Nurse ( RN ) to join our team. If you have a ... will have: + State of Maine licensure as a Registered Nurse ( RN ) or ability...ability to obtain in a timely fashion, required + Utilization Review or Care Management experience is… more
    MaineGeneral Health (06/26/25)
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  • Clinical Auditor Registered Nurse

    Humana (Jackson, MS)
    …of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied...one, (1), year of experience auditing and/or performing case management or utilization management chart… more
    Humana (06/26/25)
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  • Case Manager Registered Nurse

    RWJBarnabas Health (Livingston, NJ)
    Case Manager Registered Nurse ( RN ), Case Management (per diem)Req #:0000191479 Category:Nursing Status:Per Diem Shift:Day Facility:Cooperman Barnabas ... NJ 07039 Job Title: Case Manager Registered Nurse ( RN ), Case Management (per...setting + Minimum of one year experience in Case Management / Utilization Management or Home Care… more
    RWJBarnabas Health (03/29/25)
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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 (06/04/25)
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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 Care…

    AdventHealth (Bolingbrook, IL)
    …skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associate's degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... documents avoidable days, and facilitates progression of care. . Collaborates with Utilization Management staff for collaboration on patient status changes and… more
    AdventHealth (06/18/25)
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