• Utilization Review Nurse…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...implemented for compliance, as needed. + As a unit supervisor at the LA General Medical Center: + Has… more
    The County of Los Angeles (12/25/25)
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  • Utilization Review Nurse…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
    The County of Los Angeles (12/27/25)
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  • Clinical Supervisor Utilization

    Martin's Point Health Care (Portland, ME)
    …Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of authorization requests, ... organizational determinations/ disputes, and auditing/training of utilization review staff. Regularly monitors daily workload, volumes, metrics, production, and… more
    Martin's Point Health Care (12/23/25)
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  • Utilization Management Supervisor

    CareFirst (Baltimore, MD)
    …accreditation standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft Office ... & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health… more
    CareFirst (11/22/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + Functions ... services + Perform other duties as assigned by the supervisor including but not limited to processing concurrent denials....Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
    BayCare Health System (10/10/25)
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  • Utilization Review Registered Nurse

    BJC HealthCare (St. Louis, MO)
    …of RN experience performing care for hospitalized patients + 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity + ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization more
    BJC HealthCare (12/30/25)
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  • Utilization Management Reviewer, RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
    Excellus BlueCross BlueShield (10/07/25)
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  • RN Utilization Mgmt I

    Covenant Health Inc. (Knoxville, TN)
    …meetings between physicians and payors as applicable. + Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health. + ... Overview Registered Nurse Utilization Management Full Time, 80 Hours Per Pay...to non-clinical precertification staff. + Assists with delayed claims review to determine appropriate number of observation hours as… more
    Covenant Health Inc. (12/18/25)
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  • Hospice Clinical Coordinator

    Elara Caring (Topeka, KS)
    …productivity. + Assists staff in maintaining current and accurate medical records and utilization review . + Assists clinical supervisor with non-clinical ... phone inquiries. + Notifies supervisor of any problems requiring administrative attention and intervention. + Processes and distributes in and out daily mail for the department, collects and maintains inventory, and cleans equipment. + Implements all… more
    Elara Caring (12/09/25)
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  • Utilization Case Manager

    Helio Health Inc. (Syracuse, NY)
    …degree preferred. + Licensed/credentialed applicants preferred. + Two years of experience in utilization review in a hospital, health care, or managed care ... of federal and state regulations applicable to treatment and reimbursement. + Utilization review procedures and techniques. Our Comprehensive Employee Benefits… more
    Helio Health Inc. (12/02/25)
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