• RN Utilization Manager - (Per…

    UNC Health Care (Smithfield, NC)
    …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
    UNC Health Care (08/25/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... ) required or completed within three years of hire **Title:** * Utilization Review Manager * **Location:** *MN-Minneapolis-Downtown Campus* **Requisition… more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …why Catholic Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and ... for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of...care to MCC in response to physician order, or review of updated clinical information Acts as a resource… more
    Catholic Health Services (07/24/25)
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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who ... **Join Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff… more
    Beth Israel Lahey Health (07/29/25)
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  • Utilization Manager Reviewer…

    Excellus BlueCross BlueShield (Rochester, NY)
    …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management to address member… more
    Excellus BlueCross BlueShield (08/23/25)
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  • Utilization Management Manager…

    CareFirst (Baltimore, MD)
    …+ Proficient in Microsoft Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\ RN - Registered Nurse - State Licensure and/or ... required work experience. **Experience:** 5 years Experience in a clinical and utilization review roles. 1 year demonstrated progressive leadership experience.… more
    CareFirst (07/12/25)
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  • Manager , Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse … more
    Children's Mercy Kansas City (06/17/25)
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  • Manager Utilization Management

    Intermountain Health (Las Vegas, NV)
    …+ Continuous Improvement + Scheduling **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice ... 5:30 pm Holiday and weekend coverage when needed. The Manager of Care Management I leads and collaborates with...I leads and collaborates with care management operations across utilization review , acute and emergency department care,… more
    Intermountain Health (09/09/25)
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  • Outcomes Manager , Utilization…

    Virtua Health (Pennsauken, NJ)
    …Nursing.Training/Certifications/Licensure:Licensure from the State of New Jersey as a Registered Nurse .Case Management Certification (requirement within one year ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
    Virtua Health (08/26/25)
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  • Utilization Review RN Case…

    Penn Medicine (Philadelphia, PA)
    …assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. Education or ... Equivalent Experience: + Bachelor of Arts or Science (Required) + Utilization Review experience (Required) + Bachelor's Degree in Nursing required.2+ years… more
    Penn Medicine (08/19/25)
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