- VitalCore Health Strategies (Hopkinton, MA)
- …Insurance Employee Assistance Program and Discount Center 401K EEO Keywords: Utilization Management, RN, Nurse , Administrative, #INDMA Compensation details: ... (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… more
- VitalCore Health Strategies (Nashville, TN)
- …Health Care has an opening for a Health Services Administrator / Registered Nurse at Davidson County Downtown Detention Facility in Nashville, TN!! This position ... will be filled by a Registered Nurse . VitalCore's Corporate Office is in Kansas with Regional...The Health Services Administrator (HSA) is the chief administrative manager of the on-site health services department. The HSA… more
- VitalCore Health Strategies (Ogden, UT)
- …Health Care, has an opening for a Health Services Administrator / Registered Nurse at Weber County Correctional Facility in Ogden, Utah! This position will be ... filled by a Registered Nurse . VitalCore's Corporate Office is in Kansas with Regional...The Health Services Administrator (HSA) is the chief administrative manager of the on-site health services department. The HSA… more
- University of New Mexico - Hospitals (Albuquerque, NM)
- …to experience, education, and other business and organizational considerations. Department: Utilization Management - UH FTE: 1.00 Full Time Shift: Days Position ... patient responses to interventions in collaboration with quality assurance and utilization review, maintaining interdependent follow-up as necessary * VARIANCE -… more
- University Health (San Antonio, TX)
- …and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to ... time hospital experience preferred. Work experience in case management, utilization review, or hospital quality assurance experience is preferred.… more
- University Health (San Antonio, TX)
- …recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is preferred. Must ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice... is required. National certification in related field is preferred. Case Manager Certification (CCM or ANCC) is highly… more
- Ethos Veterinary Health (Waukesha, WI)
- …stem from great medicine, outstanding client service , and best-in-class resource utilization . Hospitals excelling in these areas share common traits, including ... Veterinary Social Worker available to employees and clients Onsite Human Resource Manager Extensive training for all employees with our Learning & Development… more
- Sanford Health (Rapid City, SD)
- …Full time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a high-impact, data-driven ... while optimizing value across the care continuum. You'll shape and execute utilization strategies that become the standard for how we coordinate care, authorize… more
- YesCare Corp (Bartow, FL)
- Join YesCare as a Utilization Manager **Licensed Practical Nurse (LPN)** and play a critical role in delivering compassionate and effective patient care ... Nursing program. + **Licensure and Certification:** + Current licensure as a Practical Nurse (LPN) in the state of employment. + Active CPR certification. + **Skills… more
- Huron Consulting Group (Chicago, IL)
- …our team as the expert you are now and create your future. The Manager of Utilization Management is responsible for planning, organizing, developing, and ... directing implementation of the Utilization Review Plan and the...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Hartford HealthCare (Willimantic, CT)
- …And this is*your moment.* **Job:** **Nursing* **Organization:** **Windham Hospital* **Title:** *Registered Nurse Case Manager (RN) - Utilization Management* ... and appropriate use of hospital resources. Works under the direction of the Manager of Continuing Care and Utilization Management and in collaboration with… 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 ... Type Full Time Job Shift Any Education Level Registered Nurse (RN) Travel Percentage None Category Health Care Description...or on-call required. What You'll Do As a Case Manager / Utilization Review RN, you will:… 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 ... this position is able to cover a multitude of utilization review functions through point of entry, observation progression...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Catholic Health (Kenmore, NY)
- …Days with Weekend and Holiday Rotation Hours: 8 am- 4 pm Summary: The Registered Nurse (RN), Utilization Review, as an active member of the Middle Revenue Cycle ... and families in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with the interdisciplinary team to… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service,… more
- University of Utah Health (Salt Lake City, UT)
- …advancement, and overall patient outcomes. **Responsibilities** + Applies approved utilization criteria to monitor appropriateness of admissions with associated ... or third-party payer. + Alerts and discusses with physician/provider and case manager /discharge planner when patient no longer meets medical necessity criteria for… more
- Saint Francis Health System (OK)
- …placement in various levels of care and receipt of necessary services. The Utilization Management (UM) Registered Nurse will communicate with providers the ... issues and participate in treatment teams, Patient Care Committee, and the Utilization Review Staff Committee by providing data and contributing to the improvement… more
- US Tech Solutions (Columbia, SC)
- …Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of Care Referrals, etc.). Participates ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member advocate through… more
- CenterWell (San Juan, PR)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
