• Registered Nurse…

    Beth Israel Lahey Health (Plymouth, MA)
    …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
    Beth Israel Lahey Health (10/30/25)
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  • Registered Nurse (RN)…

    Avera (Sioux Falls, SD)
    …the Clinical Appeals Specialist to ensure tracking and trending of all Utilization Review related denials/appeals are appropriately documented. + Assists with ... clinical guidelines for level of care reviews (first level review ), and refers cases to the internal or external...the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse (RN) - Board of Nursing… more
    Avera (11/04/25)
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  • Utilization Review Analyst…

    Beth Israel Lahey Health (Burlington, MA)
    …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized… more
    Beth Israel Lahey Health (10/30/25)
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  • Staff Nurse - Utilization…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
    Minnesota Visiting Nurse Agency (11/04/25)
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  • Senior Registered Nurse - Hospital…

    Ventura County (Ventura, CA)
    Senior Registered Nurse - Hospital Management Utilization Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5061650) Apply  Senior ... Registered Nurse - Hospital Management Utilization Salary $118,668.43...general and specialized principles, practices, techniques and methods of utilization review /management, discharge planning or case management.… more
    Ventura County (09/21/25)
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  • Utilization Review Nurse…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print...-OR- OPTION II: Two (2) years of experience as a registered nurse , of which one year must be ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 -...+ A current, active license to practice as a Registered Nurse issued by the California Board… more
    The County of Los Angeles (10/06/25)
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  • Utilization Management - Registered…

    Crouse Hospital (Syracuse, NY)
    …health education and outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage ... Schedule: Full Time: 8:00am-4:30pm, requires 6 weekends a year. Utilization Management Registered Nurse (RN)...the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent… more
    Crouse Hospital (09/25/25)
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  • Utilization Review Nurse…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
    The County of Los Angeles (09/27/25)
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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 ... this position is able to cover a multitude of utilization review functions through point of entry,...management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --… more
    Houston Methodist (11/02/25)
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  • Utilization Management Registered…

    AdventHealth (Orlando, FL)
    …water, creating a holistic environment. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +… more
    AdventHealth (11/03/25)
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