• PRN Utilization Review

    Community Health Systems (Franklin, TN)
    **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and ... timely authorizations for hospital admissions and extended stays. The Utilization Review Coordinator monitors and...physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the… more
    Community Health Systems (11/15/25)
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  • Utilization Review

    Sedgwick (Nashville, TN)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign ... By joining Sedgwick, you'll be part of something truly meaningful. It's what our...utilization review requests; to verify and enter data in appropriate… more
    Sedgwick (11/01/25)
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  • *RN Coordinator - Utilization

    Henry Ford Health System (Warren, MI)
    …Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. ... Science Nursing required OR four (4) years Case Management/ Appeal/ Utilization Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES… more
    Henry Ford Health System (09/25/25)
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  • Utilization Management Administration…

    Humana (Concord, NH)
    …new systems (proficient to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... **Become a part of our caring community and help us...and help us put health first** The UM Administration Coordinator contributes to administration of utilization management.… more
    Humana (10/10/25)
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  • Utilization Management Coordinator

    Saint Francis Health System (Tulsa, OK)
    …participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to improvement of ... support to the hospital and treatment team throughout the review of patients, their placement in various levels of...4 years of related experience in behavioral health care, part of which may be experience in Behavioral health… more
    Saint Francis Health System (11/14/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: Two (2) ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...In the County of Los Angeles, a Medical Service Coordinator , CCS (https://www.governmentjobs.com/careers/lacounty/classspecs/1065117) determines medical eligibility of children referred… more
    The County of Los Angeles (10/06/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of...Statement** _University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who… more
    University of Utah Health (10/02/25)
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  • Medical Review Coordinator

    Prime Healthcare (Reno, NV)
    …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review experience is highly preferred. 3. Clinical experience in acute… more
    Prime Healthcare (11/08/25)
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  • Utilization Management CNA

    Access Dubuque (Dubuque, IA)
    …The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification ... will also triage the call to determine if a Utilization Review Nurse is needed to complete...Health Care Insurance Location Dubuque, IA Job Type Employee Full/ Part Full Time Company ID 943 Job REQ #… more
    Access Dubuque (10/25/25)
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  • Social Worker (Program Coordinator )

    Veterans Affairs, Veterans Health Administration (Albany, NY)
    …to track service activities including visits, referrals, caregiver demographics, equipment utilization and caregiver and Veteran satisfaction. The coordinator ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA Careers - Social Work:… more
    Veterans Affairs, Veterans Health Administration (11/16/25)
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