- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Community Health Systems (Franklin, TN)
- …appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for...extended stays, identifying opportunities for process improvements to enhance utilization management . + Serves as a key… more
- Penn Medicine (Lancaster, PA)
- …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate ... we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions...**Minimum Required Qualifications:** + Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing +… more
- Katmai (Fort Carson, CO)
- …(BSN) is required. + Minimum of two (2) years of prior experience in Utilization Management . + Must possess a current, active, full, and unrestricted Registered ... licensed in Colorado, be able to practice using a nurse compact state license or have a license from...checks. **DESIRED QUALIFICATIONS & SKILLS** + Certification by a Utilization Management -specific program such as Certified Professional… more
- UNC Health Care (Kinston, NC)
- …applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience preferred. + Minimum 1 ... support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying established… more
- TEKsystems (Los Angeles, CA)
- …Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... LVN or RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
- MyFlorida (Marianna, FL)
- REGISTERED NURSE SPECIALIST - 67036112 - SUNLAND - Out Patient Clinc Date: Dec 31, 2025 The State Personnel System is an E-Verify employer. For more information ... Agency: Agency for Persons with Disabilities Working Title: REGISTERED NURSE SPECIALIST - 67036112 - SUNLAND -...dynamics. This position with APD will serve staff and management across the Agency. Your work will impact the… more
- 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 ... Nurse licensure required. 2. Current state of Illinois Advanced Practice Nurse - Certified Clinical Nurse Specialist licensure required. 3. Graduate… more
- MyFlorida (Pinellas Park, FL)
- REGISTERED NURSE SPECIALIST - 64038853 Date: Dec 17, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 867074 Agency: Department of Health Working Title: REGISTERED NURSE SPECIALIST - 64038853 Pay Plan: Career Service Position Number:… more
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