• Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    Management is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible ... reports to the Director of Utilization Management * Oversees clinical decision review for...reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison… more
    Commonwealth Care Alliance (10/02/25)
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  • UM Prior Authorization Review Nurse

    UCLA Health (Los Angeles, CA)
    Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards,...+ A minimum of three years of experience in utilization management , preferred + Team leading or… more
    UCLA Health (10/03/25)
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  • CSI Analyst ( Nurse Licensure required)…

    Premier Health (Dayton, OH)
    …experience Prior job title or occupational experience: Case management , utilization review , clinical nurse Prior specific functional responsibilities: ... with knowledge and expertise in process analysis, clinical outcome data analysis, utilization management , utilization of information systems and regulatory… more
    Premier Health (10/04/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management more
    The County of Los Angeles (10/06/25)
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  • Utilization Review Nurse

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 250924-5613FP-001 Location East Hartford, CT Date Opened 9/30/2025 12:00:00 AM ... (https://portal.ct.gov/dds/searchable-archive/northregion/north-region/welcome-to-the-north-region?language=en\_US) - is accepting applications for a full-time Utilization Review Nurse Coordinator… more
    State of Connecticut, Department of Administrative Services (10/01/25)
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  • Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department in a*/*FLOAT*/*/assignment to support Inpatient, Psych and ... needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for… more
    Minnesota Visiting Nurse Agency (10/02/25)
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  • Utilization Review and Nurse

    Idaho Division of Human Resources (Nampa, ID)
    Utilization Review and Nurse Educator - SHW Posting Begin Date: 2025/09/22 Posting End Date: 2025/10/20 Category: Nursing Work Type: Full Time Location: ... experiencedRegistered Nurse Seniorto take on a critical role in our Utilization Review , Performance Improvement, Nursing Education programs. This is an… more
    Idaho Division of Human Resources (09/23/25)
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  • Utilization Review Nurse

    Emory Healthcare/Emory University (Decatur, GA)
    …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / ... . This individual will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization more
    Emory Healthcare/Emory University (10/02/25)
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  • Behavioral Health Utilization Review

    Actalent (Sunrise, FL)
    …Health Utilization Review NurseJob Description We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an ... experience. + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman Criteria,… more
    Actalent (10/10/25)
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  • Behavioral Health Utilization Review

    Actalent (Sunrise, FL)
    Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing ... Qualifications + Valid Florida Driver's License. + Knowledge of case management and utilization review concepts, including InterQual and Milliman Criteria. +… more
    Actalent (10/10/25)
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