• Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
    Commonwealth Care Alliance (10/02/25)
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  • Sr Utilization Review Specialist

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the ... the Utilization Review Nurse and Utilization Review Specialist Nurse job...special project activities related but not limited to, throughput, utilization review and utilization management more
    Houston Methodist (08/26/25)
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  • Utilization Management

    Vanderbilt University Medical Center (Tullahoma, TN)
    …preeminent programs in patient care, education, and research. **Organization:** Utilization Management 10 **Job Summary:** Facilitates optimal reimbursement ... ensuring that the appropriate admission status is ordered. The nurse conducts initial admission based on utilization ...The nurse conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary… more
    Vanderbilt University Medical Center (09/22/25)
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  • Regional Utilization Review Documentation…

    Trinity Health (Maywood, IL)
    …is Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We… more
    Trinity Health (10/01/25)
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  • RN Utilization Review Specialist Per…

    HonorHealth (AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of ... an acute care setting. Required1 year experience in UR/UM or Case Management RequiredLicenses and CertificationsRegistered Nurse (RN) State And/Or Compact State… more
    HonorHealth (09/10/25)
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  • Insurance Specialist -Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
    Mount Sinai Health System (07/23/25)
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  • Registered Nurse Specialist

    MyFlorida (Macclenny, FL)
    REGISTERED NURSE SPECIALIST - 60042416 Date: Sep 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 861824 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST - 60042416 Pay Plan: Career...knowledgeable of and utilize the principles of Total Quality Management . Nursing will provide guidance in the care and… more
    MyFlorida (10/01/25)
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  • Registered Nurse Specialist -F/C

    MyFlorida (Gainesville, FL)
    REGISTERED NURSE SPECIALIST -F/C - 60066788 Date: Sep 19, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... . Requisition No: 861221 Agency: Children and Families Working Title: REGISTERED NURSE SPECIALIST -F/C - 60066788 Pay Plan: Career Service Position Number:… more
    MyFlorida (09/20/25)
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  • Clinical Nurse Specialist , Neuro…

    Rush University Medical Center (Chicago, IL)
    …an integrated role of practice, education, administration and research. The Clinical Nurse Specialist exemplifies the Rush mission, vision, and values and ... veteran status, and other legally protected characteristics. **Position** Clinical Nurse Specialist , Neuro & Surgical IMCUs **Location** US:IL:Chicago… more
    Rush University Medical Center (09/25/25)
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  • Sr Spec-Integrated Care Mgmt - Utilization

    Sharp HealthCare (San Diego, CA)
    …will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM. ... will track and maintain this certification.For Sr Spec ICM assigned to Utilization Management , Train-the-Trainer certification may substitute for ACM or CCM.… more
    Sharp HealthCare (08/02/25)
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