• Utilization Management…

    Cleveland Clinic (Cleveland, OH)
    …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...School of Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic… more
    Cleveland Clinic (10/18/25)
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  • Utilization Management…

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse -...**Experience:** 5 years Clinical nursing experience. 2 years Care Management and/or Utilization Management . **Preferred… more
    CareFirst (10/29/25)
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  • Utilization Management…

    AnMed Health (Anderson, SC)
    …here. This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These ... necessity review, continued stay/concurrent review, retrospective review, bed status management , resource utilization management , regulatory compliance,… more
    AnMed Health (11/13/25)
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  • RN - Utilization Review

    UnityPoint Health (Cedar Rapids, IA)
    …Adolescent Treatmt/Child S + Shift: 0900-1700 + Job ID: 174223 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient ... clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management ...health care decision-making. Qualifications + State of Iowa Licensed RN + Two years of behavioral health work experience.… more
    UnityPoint Health (11/07/25)
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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 ... includes three years in utilization review and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State… more
    Houston Methodist (11/02/25)
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  • Registered Nurse RN…

    AdventHealth (Maitland, FL)
    …8am-4:30pm (weekend rotation)** **Location** : 600 Courtland Street, Maitland **The Care Transitions Registered Nurse ensures that a care plan is carried out in ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...State of Florida or multi state license as a Registered Nurse + Basic Life Support (BLS)… more
    AdventHealth (09/16/25)
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  • Registered Nurse , RN…

    Tufts Medicine (Melrose, MA)
    …in developing and maintaining an infrastructure for the systematic review and management of complex patients. The position will work closely with PHO medical ... to review patient records, analyze data, and identify practice and patient outlier utilization , and gaps in quality measures for weekly practice and medical director… more
    Tufts Medicine (11/29/25)
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  • Registered Nurse Specialist

    MyFlorida (Clearwater, FL)
    68061397 - REGISTERED NURSE SPECIALIST Date: Nov 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Agency for Health Care Administration Working Title: 68061397 - REGISTERED NURSE SPECIALIST Pay Plan:...individual, team member or team leader. As assigned by management , this position is required to successfully complete the… more
    MyFlorida (11/25/25)
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  • Registered Nurse - Clinical…

    Cedars-Sinai (Los Angeles, CA)
    …Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8 Hour Days ... care field preferred Foreign trained MDs will be considered License/Certifications: Registered Nurse , LVN, Occupational Therapist, Physical Therapist, Physician… more
    Cedars-Sinai (09/18/25)
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  • RN Utilization Review…

    Corewell Health (Caledonia, MI)
    …acute care, clinical nursing, preferably multiple clinical settings, or related experience Required + Registered Nurse ( RN ) - State of Michigan required How ... and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and… more
    Corewell Health (12/02/25)
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