• Utilization Manager…

    Commonwealth Care Alliance (Boston, MA)
    013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring… more
    Commonwealth Care Alliance (10/02/25)
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  • Registered Nurse (RN)…

    Monroe County, NY (Rochester, NY)
    Full Jobs List Full Exams List Registered Nurse (RN) - Utilization Review Unit, Per Diem Location: Rochester, NY Title: Registered Nurse (RN) - ... to, and works under the general supervision of a Nurse Manager , or other higher-level staff member....Qualifications Possession of a New York State License as a Registered Nurse . Download/View Full Announcement Apply… more
    Monroe County, NY (08/02/25)
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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 (08/16/25)
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  • Utilization Review Nurse Coordinator…

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    …Apply View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse (RN) interested in a career where you can ... Utilization Review Nurse Coordinator (40 Hour)...(https://www.elicense.ct.gov/) online (expand the 'Public Health Practitioners' grouping, select ' Registered Nurse ' and then 'Start'; + Request… more
    State of Connecticut, Department of Administrative Services (10/01/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated… more
    University of Utah Health (10/02/25)
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  • Utilization Review Nurse - Full Time

    Dayton Children's Hospital (Dayton, OH)
    …preferred Education Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN: Registered Nurse (RN) - Ohio Board of Nursing At ... Utilization Review TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review… more
    Dayton Children's Hospital (10/04/25)
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  • Nurse Supervisor, Healthcare Services…

    Molina Healthcare (Los Angeles, CA)
    …must be current and in good standing. **Preferred Qualifications** * LVN (Licensed vocational nurse ) or RN ( Registered Nurse ) . License must be current, ... in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS),… more
    Molina Healthcare (09/25/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …our nurses set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** ... their passion for patient care. Apply today for our Registered Nurse Case Manager opportunity....and overall evaluation of individual patient needs. Care coordination, utilization review and management, as well as discharge planning… more
    HCA Healthcare (09/20/25)
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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 ... 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 (07/16/25)
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  • Registered Nurse Case Manager…

    Tenet Healthcare (Detroit, MI)
    Registered Nurse Case Manager Contingent Days - 2506002318 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart ... physicians throughout the nation. Job Description: The RN Case Manager is responsible to facilitate care along a continuum...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
    Tenet Healthcare (08/29/25)
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