• Utilization Review Case

    Holzer Health System (Gallipolis, OH)
    …organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers ... field will be taken into consideration. . Professional experience with case management, utilization review , or discharge planning highly desirable. .… more
    Holzer Health System (07/24/25)
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  • Case Manager Utilization

    Beth Israel Lahey Health (Burlington, MA)
    …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality...Case Manager experience as well as Utilization Review experience ( review medical… more
    Beth Israel Lahey Health (05/11/25)
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  • RN/ Case Manager -MSH- Case

    Mount Sinai Health System (New York, NY)
    …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager MSH Case ...a Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case more
    Mount Sinai Health System (07/15/25)
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  • RN/ Case Manager -Inpatient-Mount…

    Mount Sinai Health System (New York, NY)
    …preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** **RN/ Case Manager Inpatient Mount Sinai West...1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case more
    Mount Sinai Health System (07/08/25)
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  • Per Diem RN Case Manager

    Children's Hospital Boston (Boston, MA)
    80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care ... required, pediatric experience preferred. + Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/… more
    Children's Hospital Boston (06/16/25)
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  • Case Manager RN Utilization

    Providence (Anchorage, AK)
    …Medical Surgical or Inpatient setting. + IRR or annual competency testing in Utilization Review . **Preferred Qualifications:** + Bachelor's Degree in Nursing or ... specialty. + 1 year experience in care management or utilization review in any setting or successful...any setting or successful completion of TIPS program or Case Management Orientation Program. **Why Join Providence?** Our best-in-class… more
    Providence (06/27/25)
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  • Case Manager , RN…

    Prime Healthcare (Lynwood, CA)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/212260/ case - manager %2c-rn ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.3. Five years acute care… more
    Prime Healthcare (06/24/25)
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  • Enhanced Care Management Clinical Specialist II

    LA Care Health Plan (Los Angeles, CA)
    …California License. Licenses/Certifications Preferred Certified Professional in Utilization Review (CPUR) Certified Case Manager (CCM) Required ... Information Preferred: Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or… more
    LA Care Health Plan (07/16/25)
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  • Registered Nurse - Case Manager

    Mayo Clinic (Rochester, MN)
    …physicians and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and ... resource utilization , and clinical documentation. The RN Case Manager will function within the Mayo...within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records,… more
    Mayo Clinic (06/14/25)
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  • Utilization Review Nurse…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members,...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/12/25)
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