• Utilization Review…

    Sedgwick (Providence, RI)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign ... utilization review requests; to verify and enter data in appropriate...and RESPONSIBILITIES** + Accesses, triages and assigns cases for utilization review (UR). + Responds to telephone… more
    Sedgwick (01/19/26)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Providence, RI)
    … or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
    Humana (12/12/25)
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  • Clinical Data and QA Coordinator

    Northeast Family Services (Warwick, RI)
    …with interactions of staff + Participate in development of training plans for data utilization + Acts as project coordinator for all Clinical Quality related ... join our growing team as Clinical Data and Quality Coordinator . As an important member of the operations and...role, as well as establishing KPIs, QA Plans, data utilization , monitoring, and reporting on compliance. If you're looking… more
    Northeast Family Services (01/16/26)
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  • Case Manager, Registered Nurse (Oncology…

    CVS Health (RI)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (01/21/26)
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  • Associate Project Manager - Cybersecurity

    SHI (Providence, RI)
    …position will schedule resources, manage escalations, track hours and budget, review deliverables, and maintain clear communication with stakeholders on project ... closure which includes project acceptance,andfinal invoicing, andconduct a thorough review toidentifylessons learned and best practices for future projects +… more
    SHI (12/10/25)
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