- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management /Inpatient Care Coordination Nurse Manager demonstrates leadership expertise in regards inpatient care coordination and ... experience such as Charge Nurse or Nurse Manager Minimum of two years Utilization Management experience Minimum five years varied RN clinical… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) ... service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Ellis Medicine (Schenectady, NY)
- …is to work with the Social Worker, Nurse Case Manager , or Utilization Management Nurse to facilitate patient discharge plans, support coordination of ... beneficiaries per CMS Conditions of Participation at the direction of the Case Manager . + Utilization Management Activities: + Collaborates with Case… more
- Trinity Health (Chelsea, MI)
- …time **Shift:** Rotating Shift **Description:** **Registered Nurse ** **Case Manager ** **Department:** Utilization Management **Location:** Chelsea, MI ... Trinity Health + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our vision and serve with us… more
- 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 Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- Molina Healthcare (Los Angeles, CA)
- …services professionals in some or all of the following functions: care management , utilization management , behavioral health, care transitions, long-term ... * Assists in implementing health management , care management , utilization management , behavioral health...unrestricted in the state of California. * Certified Case Manager (CCM), Certified Professional in Health Care Management… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests ... reports on department activities as assigned. Essential Skills + Experience in utilization management , behavioral health, and mental health. + Proficiency in… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** +… more
- Dayton Children's Hospital (Dayton, OH)
- …Utilization Review TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization Management , the Utilization ... information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource to the...a resource to the physicians, collaborates with the Care Manager in the development and implementation of the plan… more
- Commonwealth Care Alliance (Boston, MA)
- …services, procedures, and facilities under the provisions of CCA's benefits plan. The Manager , Utilization Management is responsible for overseeing and ... managing the daily operation of the Utilization Management Review Nurse and...decisions and organizational determinations. Essential Duties & Responsibilities: The Manager , Utilization Management reports to… more