• Registered Nurse Quality & Patient…

    Veterans Affairs, Veterans Health Administration (Houston, TX)
    Summary The Registered Nurse Quality & Patient Safety Nurse Manager - Utilization Management functions as a clinical expert and is responsible and ... not limited to): The Registered Nurse Quality & Patient Safety Nurse Manager is the designated first-line supervisory authority and is responsible and… more
    Veterans Affairs, Veterans Health Administration (07/16/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Type:** Part time **Shift:** Day Shift **Description:** ** Registered Nurse ** **Case Manager ** **Department:** Utilization Management **Location:** ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all members of… more
    Trinity Health (07/24/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Type:** Part time **Shift:** Rotating Shift **Description:** ** Registered Nurse ** **Case Manager ** **Department:** Utilization Management **Location:** ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all members of… more
    Trinity Health (06/04/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Houston, TX)
    Summary The Registered Nurse Utilization Management Registered Nurse delivers fundamental knowledge-based care to assigned clients while developing ... policies and guidelines. Responsibilities Major Duties (To include but not limited to): The Registered Nurse Utilization Management Registered Nurse more
    Veterans Affairs, Veterans Health Administration (07/21/25)
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  • Utilization Review - Registered

    Community Health Systems (Naples, FL)
    …written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure Current ... **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical… more
    Community Health Systems (07/12/25)
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  • Registered Nurse

    Beth Israel Lahey Health (Plymouth, MA)
    …the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding cases that do not meet established ... 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 (05/17/25)
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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 and ... the physicians and provides education and information on resource utilization and national and local coverage determinations (LCDs &...management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --… more
    Houston Methodist (07/25/25)
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  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    …requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California ... Utilization Management Nurse Specialist RN II...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
    LA Care Health Plan (07/08/25)
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  • Utilization Review Nurse

    Dignity Health (Carmichael, CA)
    **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for the ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is...five (5) years of nursing experience. + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
    Dignity Health (07/25/25)
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  • Registered Nurse - Case…

    WellSpan Health (Lebanon, PA)
    … Management, Case Management, or Clinical Nursing Specialty. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required or + Registered ... 4pm Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of… more
    WellSpan Health (07/22/25)
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