• Nurse Manager - Med Surg/ED - Idmh

    Arnot Health (Bath, NY)
    …areas suitable for nursing research. + Promotes research-based practice. Standard VIII. Resource Utilization The Nurse Manager evaluates and administers the ... Professional Performance Standard I. Quality of Care and Administrative Practice The Nurse Manager systematically evaluates the quality and effectiveness of… more
    Arnot Health (06/10/25)
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  • Registered Nurse Case Manager

    Prime Healthcare (Weslaco, TX)
    …Shift Days Connect With Us! (https://careers-primehealthcare.icims.com/jobs/210205/registered- nurse -case- manager utilization ... -management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityKnapp Medical Center LocationUS-TX-Weslaco ID2025-210205 CategoryClinical Professional Position TypeFull Time ShiftDays Job TypeNon-Exempt more
    Prime Healthcare (06/06/25)
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  • Nurse Utilization Management…

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
    Commonwealth Care Alliance (05/23/25)
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  • Case Manager Utilization Review…

    Beth Israel Lahey Health (Burlington, MA)
    …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review, discharge planning and monitors quality assurance for Lahey… more
    Beth Israel Lahey Health (05/11/25)
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  • Quality Assurance Manager , Clinical…

    CareOregon (Portland, OR)
    Manager Direct Reports Registered Nurse - Clinical Quality Assurance, Registered Nurse - Utilization Management II Manager Title Director, Quality ... Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Quality Assurance Manager , Clinical Systems Requisition # 25017 Exemption Status Exempt Management Level… more
    CareOregon (06/11/25)
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  • Utilization Review Specialist Nurse

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry ... this position is able to cover a multitude of utilization review functions through point of entry, observation progression...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
    Houston Methodist (06/21/25)
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  • Utilization Review Nurse

    Actalent (Sunrise, FL)
    Utilization Management Nurse !Job Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing service authorization requests to ... ensure appropriate service utilization . Working under the general supervision of the Director...Working under the general supervision of the Director and/or Manager /Supervisor of Medical Management, and in collaboration with an… more
    Actalent (06/21/25)
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  • Utilization Review Nurse - Emergency…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... resource to the physicians and provides education and information on resource utilization and national and local coverage determinations (LCDs & NCDs). This position… more
    Houston Methodist (06/06/25)
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  • Utilization Management Nurse

    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 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (06/13/25)
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  • Clinical Reviewer Outpatient Utilization

    US Tech Solutions (Canton, MA)
    …required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that is expected to function independently in her / his ... UM team and works under the general direction of the Precertification Team Manager or department Manager . The Clinical Reviewer is expected to demonstrate… more
    US Tech Solutions (06/23/25)
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