• Utilization Management

    Cleveland Clinic (Cleveland, OH)
    …career with one of the most respected healthcare organizations in the world. As a Utilization Management Specialist , you will perform UM activities, such as ... a minimum of 85% on IRR quarterly. + Complete Utilization Management for assigned patients with a...School of Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic… more
    Cleveland Clinic (05/09/25)
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  • Utilization Management

    Penn State Health (Hershey, PA)
    …status, and family medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - Utilization ... maintaining compliance with the CMS Conditions of Participation for Utilization Management . MINIMUM QUALIFICATIONS: * Bachelors Degree...setting required. * Currently licensed to practice as a Registered Nurse by state of employment or… more
    Penn State Health (05/13/25)
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  • Utilization Management

    Penn Medicine (Lancaster, PA)
    …each day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical ... duties as assigned. Responsibilities: Minimum Required Qualifications: + Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing +… more
    Penn Medicine (05/01/25)
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  • Specialist (Part-time) - Varied Shifts…

    Penn State Health (Hershey, PA)
    …###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) Penn State Health is seeking a dedicated ** Utilization Management Specialist ** to join our ... is required. + Currently licensed to practice as a Registered Nurse by the state of employment...**Position** Specialist (Part-time) - VARIED SHIFTS - Utilization Management **Location** US:PA: Hershey | Nursing… more
    Penn State Health (04/17/25)
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  • Utilization Management

    Sanford Health (Sioux Falls, SD)
    …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... Conduct level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to… more
    Sanford Health (03/13/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting ... & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA) Utilization Management (Authorization) Unit is primarily responsible for the… more
    Commonwealth Care Alliance (05/21/25)
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  • Registered Nurse Utilization

    LifePoint Health (Louisburg, NC)
    Registered Nurse ( RN ) Utilization Review Job...the lives of those we serve. Connect with our RN recruiting specialist . Do you need more time ... as an employee but as a person. As a registered nurse ( RN ) joining our...a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review Coordinator*… more
    LifePoint Health (05/15/25)
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  • Registered Nurse ( RN )- Case…

    LifePoint Health (Johnstown, PA)
    …in employment. **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN )- Case Management PRN/Hourly* **Location:** ... * Registered Nurse ( RN ), Case Manager...in the care of hospitalized patients. Our team of RN Case Managers, Social Workers, Utilization Review staff,… more
    LifePoint Health (03/30/25)
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  • RN Registered Nurse Care…

    AdventHealth (Hinsdale, IL)
    …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... . BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION… more
    AdventHealth (05/16/25)
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  • Registered Nurse RN Case…

    AdventHealth (Fletcher, NC)
    …Flat Rock, Flat Rock, Tuxedo and Zirconia.** **The role you'll contribute:** The Home Health Registered Nurse ( RN ) Care Manager is a professional nurse ... care patient's care based on individual patient needs. The RN Care Manager is responsible for independent management...**1 years relevant clinical RN experience** + ** RN - Registered Nurse -… more
    AdventHealth (04/09/25)
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