• Physician Utilization Review Specialist Per…

    Hackensack Meridian Health (Hackensack, NJ)
    … d. Clarifying ambiguous or conflicting documentation e. Target DRGs Reviews f. Use of case manager as a resource + Uses guidelines to evaluate patient status ... more
    Hackensack Meridian Health (02/16/25)
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  • Sr Utilization Review Spec FT Humc

    Hackensack Meridian Health (Hackensack, NJ)
    …iii. Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status ... more
    Hackensack Meridian Health (02/01/25)
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  • Nurse Care Manager 1

    Rush University Medical Center (Chicago, IL)
    …vary depending on the circumstances of each case . **Summary:** The Nurse Care Manager 1 works with physician practices and inpatient teams to promote the ... more
    Rush University Medical Center (03/05/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Lexington, KY)
    …as outlined below + KentuckyRN:KY or Compact **Preferred Licensure and Certifications** + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), ... more
    Catholic Health Initiatives (03/04/25)
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  • Clinical Evaluation Manager

    VNS Health (Manhattan, NY)
    …Professional Nurse or an Occupational Therapist in New York State required Certified Case Manager preferred For SelectHealth ETE Only: Nurse Practitioner (NP) ... more
    VNS Health (03/11/25)
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  • Clinical Evaluation Manager -mostly remote…

    VNS Health (Manhattan, NY)
    …Professional Nurse or an Occupational Therapist in New York State required + Certified Case Manager preferred Education: + Associate's Degree in Nursing or a ... more
    VNS Health (03/07/25)
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  • Utilization Review Nurse

    University of Utah Health (South Salt Lake, UT)
    …members or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity ... more
    University of Utah Health (02/08/25)
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  • Clinical Evaluation Manager

    VNS Health (Manhattan, NY)
    …Professional Nurse or an Occupational Therapist in New York State required + Certified Case Manager preferred Education: + Associate's Degree in Nursing or a ... more
    VNS Health (03/11/25)
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  • Utilization Review Specialist Senior

    BayCare Health System (St. Petersburg, FL)
    …RN (Registered Nurse) + Preferred ACM ( Case Management) + Preferred CCM ( Case Manager ) **Education:** + Required Associates in Nursing or + Required ... more
    BayCare Health System (03/12/25)
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  • Utilization Review Spec Sr

    BayCare Health System (Clearwater, FL)
    …RN (Registered Nurse) + Preferred ACM ( Case Management) + Preferred CCM ( Case Manager ) **Education:** + Required Associates in Nursing or + Required ... more
    BayCare Health System (12/31/24)
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  • Registered Nurse RN Care Manager PRN

    AdventHealth (Kissimmee, FL)
    …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the ... more
    AdventHealth (02/11/25)
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  • Utilization Review RN

    Dignity Health (Santa Maria, CA)
    …At least five (5) years of nursing experience **Preferred Licensure and Certifications** Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), ... more
    Dignity Health (02/14/25)
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  • Social Worker/Nurse- Care Manager Weekend…

    AdventHealth (Shawnee, KS)
    ** Inpatient Social Worker OR RN- Case Manager Weekend Worker Program Days** **All the benefits and perks you need for you and your family:** + Vision, Medical ... more
    AdventHealth (03/05/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Columbus, OH)
    …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... more
    Molina Healthcare (01/25/25)
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  • RN Care Manager PRN

    AdventHealth (Orange City, FL)
    …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the ... more
    AdventHealth (03/12/25)
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  • Social Worker Patient Care Manager - BSW,…

    Munson Healthcare (Gaylord, MI)
    SUMMARY The Patient Care Manager facilitates progression-of-care and monitors the patient's progress to ensure that the plan of care and services provided are ... more
    Munson Healthcare (03/04/25)
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  • RN Utilization Manager - Medicine,…

    UNC Health Care (Chapel Hill, NC)
    …and accurate documentation of patient data and treatments. Communicates daily with the Case Manager to manage level of care transitions & appropriate utilization ... more
    UNC Health Care (03/06/25)
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  • Manager , Healthcare Services - Behavioral…

    Molina Healthcare (Chesapeake, VA)
    …following activities: care review /utilization management (prior authorizations, inpatient /outpatient medical necessity, etc.), case management, transition of ... more
    Molina Healthcare (02/09/25)
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  • RN Registered Nurse Care Manager

    AdventHealth (Hinsdale, IL)
    …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the ... more
    AdventHealth (02/14/25)
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  • Social Work Care Manager

    AdventHealth (La Grange, IL)
    …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the ... more
    AdventHealth (02/13/25)
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