• Quality / Utilization Review…

    George C. Grape Community Hospital (Hamburg, IA)
    Quality / Utilization Review Nurse Position Summary: The Quality / Utilization Review Nurse is responsible for evaluating the medical ... years of clinical nursing experience (acute care preferred). o Prior experience in utilization review , case management, quality improvement, and infection… more
    George C. Grape Community Hospital (11/25/25)
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  • 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 ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
    The County of Los Angeles (10/06/25)
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  • Registered Nurse - Utilization…

    Veterans Affairs, Veterans Health Administration (Winter Park, FL)
    Summary The Orlando VA Medical Center is seeking a Utilization Review Registered Nurse to join the Orlando VAMC team. The Utilization Review ... orientation, competencies and providing quality improvement and outcomes utilization consultation. Responsibilities The Utilization Review Registered… more
    Veterans Affairs, Veterans Health Administration (11/21/25)
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  • Utilization Review Specialist…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry,...the plan of care and services provided are patient-focused, high- quality , efficient, and cost-effective. Serves as a preceptor and… more
    Houston Methodist (11/02/25)
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  • Staff Nurse - Utilization…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... evidence-based practice * Quality of Practice*: * Promotes quality through evidence-based utilization review ... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
    Minnesota Visiting Nurse Agency (10/02/25)
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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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
    The County of Los Angeles (09/27/25)
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  • RN Utilization Specialist/ Review…

    YesCare Corp (Brentwood, TN)
    …best practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and evaluate ... review . + Track, trend and evaluate appropriateness and quality of care issues with the implementation of education...license + No less than 5 years' experience in utilization management, case management, quality management. +… more
    YesCare Corp (10/30/25)
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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** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
    University of Utah Health (10/02/25)
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  • Medical Utilization Review…

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with ... pace and changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical… more
    Brighton Health Plan Solutions, LLC (11/22/25)
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  • Utilization Review Nurse…

    Martin's Point Health Care (Portland, ME)
    …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt ... of high quality , cost efficient medical outcomes for those enrollees with...retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use… more
    Martin's Point Health Care (11/15/25)
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