• RN Utilization Management

    Trinity Health (Columbus, OH)
    …information technology, financial analysis, audit, provider relations and more. **Position Purpose** RN Utilization Management MCHP is responsible for the ... Plan's UM Program and the review of the Plan's Utilization Management Plan. **What you will do**...Licensure / Certification: Current license to practice as a Registered Nurse in their home state or… more
    Trinity Health (12/03/25)
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  • Utilization Management Specialist…

    CareFirst (Baltimore, MD)
    …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization ...State Licensure Upon Hire Required + CNS-Clinical Nurse Specialist Preferred **Experience:** 5 years Clinical nursing experience.… more
    CareFirst (10/29/25)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review, ... initiate a Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners...etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management more
    CVS Health (11/26/25)
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  • Utilization Manager Registered

    Commonwealth Care Alliance (Boston, MA)
    …**Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in… more
    Commonwealth Care Alliance (10/02/25)
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  • Registered Nurse

    ERP International (Vandenberg AFB, CA)
    **Overview** ERP International is seeking a full-time ** Registered Nurse ( RN ) Utilization Management ** for a temporary contract position in support ... AFB, CA (https://www.airforcemedicine.af.mil/MTF/Vandenberg/About-Us/) . **NOTE: This is NOT a Tele-Health/ Remote Practice Opportunity.** **Be the Best!** Join our team… more
    ERP International (09/13/25)
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  • Registered Nurse , ER, RN

    ChenMed (St. Louis, MO)
    …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
    ChenMed (11/08/25)
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  • Registered Nurse ( RN ) Case…

    Ochsner Health (New Orleans, LA)
    …discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager - Case Management OMC Jefferson Highway PRN To perform ... experience in discharge planning, case management or utilization review. **Certifications** Required - Current registered ...or utilization review. **Certifications** Required - Current registered nurse license in state of practice.… more
    Ochsner Health (10/29/25)
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  • Registered Nurse / RN

    AccentCare, Inc. (Middlebury, CT)
    …Hospice Location: Middlebury, CT Position: Admissions Registered Nurse / RN , Hospice Position Type: Part Time Remote /Virtual Position: No Coverage Area: ... Overview Admissions Registered Nurse / RN ,...and external partners, ensuring timely updates, interventions, and resource utilization + Provide patient and caregiver education, document care… more
    AccentCare, Inc. (10/29/25)
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  • Registered Nurse RN Case…

    Banner Health (Phoenix, AZ)
    …of a bachelor's degree in case management or health care. Requires current Registered Nurse ( RN ) license in state worked. For assignments in an ... , acute care and/or home care environments, community resources and resource/ utilization management . Must demonstrate critical thinking skills, problem-solving… more
    Banner Health (11/19/25)
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  • Registered Nurse Ambulatory Care…

    Bon Secours Mercy Health (Norfolk, VA)
    …clinical and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse ( RN ), the Ambulatory Care Manager will provide ... clinical care management services to identified eligible patients; coordinating care to...Nursing Bachelor's Degree (preferred) Specialty/Major- Nursing (BSN) **Licensing/ Certification** Registered Nurse with active License in State… more
    Bon Secours Mercy Health (11/12/25)
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