• SNF Utilization Management…

    Humana (Olympia, WA)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the… more
    Humana (09/12/25)
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  • Registered Nurse ( RN )…

    Texas Health Resources (Arlington, TX)
    …Req 1 Year of acute case management /discharge planning experience Pref Licenses and Certifications RN - Registered Nurse Upon Hire Req And BCCMN - Board ... utilization review Req 1 Year of acute case management /discharge planning experience Pref Licenses and Certifications RN - Registered Nurse Upon Hire… more
    Texas Health Resources (08/29/25)
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  • Case Manager, Registered Nurse

    Sutter Health (San Francisco, CA)
    …in nursing, case management or related field. **CERTIFICATION & LICENSURE** + RN - Registered Nurse of California (required) + CCM-Certified Case Manager ... Manager is responsible for Care Coordination, Care Transitions, Discharge Planning and Utilization Management throughout the acute care patient experience. The … more
    Sutter Health (08/16/25)
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  • Registered Nurse

    WMCHealth (Port Jervis, NY)
    Registered Nurse Company: St. Joseph's Place City/State: Port Jervis, NY Category: Nursing/Nursing Management Department: SNF -TCU Union: YES Union Name: ... - $53.25 Apply Now External Applicant link Internal Applicant link Job Details: The Registered Nurse provides professional nursing care in an assigned clinic or… more
    WMCHealth (09/12/25)
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  • Registered Nurse Case Manager

    Beth Israel Lahey Health (Exeter, NH)
    Registered Nurse Case Manager + Full Time + Exeter, NH 03833 ... the patient's health care needs following the current phase of illness. **Requirements** + Registered Nurse - NH State or Compact State + BSN Preferred +… more
    Beth Israel Lahey Health (06/28/25)
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  • Per Diem RN - Case Management…

    Sharp HealthCare (La Mesa, CA)
    …3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse ( RN ) - CA Board of Registered Nursing ... Manager (CCM) - Commission for Case Manager Certification; California Registered Nurse ( RN ) - CA...and individual development planning process.Maintain current knowledge of case management , utilization management , and discharge… more
    Sharp HealthCare (09/06/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Washington, DC)
    …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
    AmeriHealth Caritas (09/01/25)
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  • Managed Long Term Services and Supports…

    LA Care Health Plan (Los Angeles, CA)
    …Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... and must adhere to regulatory mandates that apply to Utilization Management (UM) and Care Management...of the member. The MLTSS Nurse Specialist RN II collaborates with Skilled Nursing Facilities ( SNF… more
    LA Care Health Plan (08/26/25)
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  • Acute Care Manager ( RN )

    ChenMed (Philadelphia, PA)
    …RN with bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse ( RN ) license in State of employment required + Compact ... the remaining hours. The Acute Care Manager, Complex Care ( RN ) is responsible for achieving positive patient outcomes, managing...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
    ChenMed (07/25/25)
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  • Intensive Community Manager, Complex Care…

    ChenMed (Oakland Park, FL)
    …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 ( RN ) role also...preferred providers. + Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute… more
    ChenMed (09/03/25)
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