• Nurse - Community Care

    Veterans Affairs, Veterans Health Administration (Winter Park, FL)
    …of care . Responsibilities The Community Care (CC) Utilization Review Registered Nurse ( RN ) is responsible for collecting, interpreting, ... care coordination for the VAHCS. The CC Utilization Review RN performs a...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (08/01/25)
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  • RN Utilization Review

    Trinity Health (Athens, GA)
    **Employment Type:** Part time **Shift:** **Description:** The Utilization Review (UR) Coordinator works, in collaboration with a multidisciplinary team that ... payers, to ensure patients progress along the continuum of care in an efficient and cost-effective manner that ensures...management and auditing duties as assigned. Participates in the Utilization Review Committee as assigned. Maintains good… more
    Trinity Health (07/31/25)
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  • Utilization Review Nurse (40…

    State of Connecticut, Department of Administrative Services (New Haven, CT)
    Utilization Review Nurse (40...care delivery and reimbursement systems; + Participates in utilization review and/or quality assurance programs; + ... (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to...care disciplines; + regulations and standards pertaining to utilization review ; + care and… more
    State of Connecticut, Department of Administrative Services (07/23/25)
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  • RN Utilization Review

    Guthrie (Binghamton, NY)
    care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service requests ... with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and...a part of a tradition of excellence in health care . In all areas and at all levels of… more
    Guthrie (07/05/25)
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  • Utilization Review Nurse

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/25/25)
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  • Utilization Management Nurse

    CVS Health (Annapolis, MD)
    …state licenses + Ability to work rotating weekends **Preferred Qualifications** + Managed care / utilization review experience preferred + Acute care ... Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of… more
    CVS Health (07/24/25)
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  • Utilization Management Nurse

    Adecco US, Inc. (Minneapolis, MN)
    …the direct supervision of an RN or MD. . Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according ... ** : . Knowledge of Home Health processes. . Registered Nurse with a current license to...applicable states . 2+ years of experience in managed care , Utilization Review , Case Management… more
    Adecco US, Inc. (07/15/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - ... of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review...accredited school of nursing. + Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing… more
    Corewell Health (06/27/25)
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  • Utilization Management Clinical Consultant

    CVS Health (Charleston, WV)
    …function. Required Qualifications: + Licensed independent Behavioral Health clinician or a Registered Nurse ( RN ) with unrestricted state license with ... experience in psychiatric setting required Preferred Qualifications: + Managed care / utilization review experience preferred +...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
    CVS Health (07/12/25)
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  • Utilization Management Nurse

    CVS Health (Madison, WI)
    care **Preferred Qualifications** + NICU experience highly preferred + Managed care / utilization review experience + Ability to multitask, prioritize and ... Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of… more
    CVS Health (07/23/25)
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