- VitalCore Health Strategies (Hopkinton, MA)
- …(VCHS), an industry leader in Correctional Healthcare, has a Full-Time opening for a Utilization Management RN at the Regional Office in Hopkinton, MA Start A New ... on respect and appreciation of the hard work and dedication of our staff. UTILIZATION MANAGEMENT RN - ESSENTIAL FUNCTIONS Essentially will serve as a Regional Office… more
- Fresenius Medical Care (Mayfield, KY)
- As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility ... opportunity thoroughly before making an application. Training and advancement: As a Clinical Manager , you may advance your career into an Area Team Lead or Director… more
- Fresenius Medical Care (Mayfield, KY)
- About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. If ... onboarding, essential functions, leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area Team Lead or… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... Manager ) required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:** *MN-Minneapolis-Downtown Campus*… more
- 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 ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs staff performance… more
- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... reporting, quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based and outcome… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/rn-case- manager utilization - ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Behavioral Center of Michigan (Warren, MI)
- …skills to help educate the staff and physicians regarding charting. REPORTS TO: Utilization Review Lead/ Manager QUALIFICATIONS: + High School Diploma or ... Under general supervision, the Utilization Review Coordinator provides professional assessment,...those duties include all tasks requested by the UR Manager , CEO or Medical Director to meet the needs… more
- UPMC (Pittsburgh, PA)
- …to candidates with a Pennsylvania RN license. The Utilization Management (UM) Care Manager is responsible for utilization review of health plan services ... UPMC Health Plan is hiring a full-time UM Care Manager to support our UM Clinical Operations team. This...information obtained from interaction with members and providers. + Review and document clinical information from health care providers… more
- Vighter Medical Group (Glendale, CO)
- …our team at the Office of Community Care (OCC) in Glendale, Colorado. As a Case Manager / Utilization Review Nurse, you'll play a key role in coordinating ... - no nights, weekends, or on-call required. What You'll Do As a Case Manager / Utilization Review RN, you will: + Conduct clinical reviews of medical records… more
- Wellpath (Franklin, TN)
- …**About this role** The Regional Care Manager (RCM) is responsible for utilization review , care coordination, and daily care management across multiple sites ... Nursing or Care Management Certification + RN preferred EXPERIENCE + Previous utilization review and/or case management and pre-certification experience +… more
- University of Utah Health (Salt Lake City, UT)
- …the accurate reporting of time and attendance of direct reports. + Functions as Case Manager and/or Utilization Review Nurse as necessary. + Tracks and ... analyzes Case Manager quality of service and utilization statistics. + Works collaboratively with information systems personnel as needed to implement case… more
- Trinity Health (Mason City, IA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Utilization Review Case Manager responsibilities include case screening, insurance ... manage all cases per established organizational standards + Discuss cases with Utilization Review Committee and/or third party entities when cases fail… more
- University of Miami (Miami, FL)
- …Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for… more
- UNC Health Care (Raleigh, NC)
- …care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management ... needs are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in… more
- LifeCenter Northwest (Bellevue, WA)
- …- $159,600.00 Salary Position Type Full Time Description and Qualifications The Manager , Organ Utilization (OUM) provides strategic leadership and operational ... results and identify areas for improvement. + Partner with the Organ Utilization Program Manager (OUPM) on OUCT staffing, onboarding, competency development,… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM ... to learn more about joining our team as a Utilization Review Nurse Coordinator! The State of...with Disabilities Act (ADA), please contact Edward Magnano, EEO Manager at (860) 418 - 6148 or ###@ct.gov PURPOSE… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
