• Utilization Management

    Fairview Health Services (St. Paul, MN)
    **Overview** M Health Fairview has an immediate opening for a Utilization Management Specialist RN . This is a 1.0 FTE (80 hours per two week pay period), ... related to denials/appeals. + Educate internal members of the health care team on utilization management workflow and managed care concepts. + Work on a variety… more
    Fairview Health Services (02/22/25)
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  • Utilization Management Nurse

    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 ... achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN...health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
    LA Care Health Plan (02/24/25)
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  • Utilization Management

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact… more
    CareFirst (02/21/25)
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  • Utilization Management

    Vanderbilt University Medical Center (Nashville, TN)
    …through preeminent programs in patient care, education, and research. **Organization:** Utilization Management 20 **Job Summary:** JOB SUMMARY Facilitates ... instead of emphasizing negative elements. **Position Qualifications:** **Responsibilities:** **Certifications:** LIC- Registered Nurse - Licensure-Others **Work Experience:** Relevant… more
    Vanderbilt University Medical Center (02/20/25)
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  • Registered Nurse RN

    AdventHealth (Orlando, FL)
    …inpatients and 125,000 outpatients each year **The role you'll contribute:** **The Care Transitions Registered Nurse ensures that a care plan is carried out in ... various other teams, including but not limited to Care Management nurses and social workers, nursing, home care liaisons,...State of Florida or multi state license as a Registered Nurse + Basic Life Support (BLS)… more
    AdventHealth (01/25/25)
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  • Registered Nurse

    Trinity Health (Maywood, IL)
    …location is Loyola campus. Position is hybrid, local candidates preferred. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We… more
    Trinity Health (02/01/25)
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  • Registered Nurse ( RN )- Case…

    LifePoint Health (Johnstown, PA)
    …in employment. **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN )- Case Management PRN/Hourly* **Location:** ... * Registered Nurse ( RN ), Case Manager...in the care of hospitalized patients. Our team of RN Case Managers, Social Workers, Utilization Review staff,… more
    LifePoint Health (02/05/25)
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  • RN Registered Nurse Care…

    AdventHealth (La Grange, IL)
    …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes… more
    AdventHealth (02/11/25)
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  • Registered Nurse ( RN ) Case…

    LifePoint Health (Henderson, NC)
    …or local law. **Job:** **Case Management /Social Services* **Organization:** ** **Title:** * Registered Nurse ( RN ) Case Manager Full Time* **Location:** ... Registered Nurse ( RN ) Case Manager Up to...in the lives of those we serve. Connect with our RN recruiting specialist . Do you need more time to… more
    LifePoint Health (01/07/25)
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  • Registered Nurse RN Care…

    AdventHealth (Orlando, FL)
    …experiences you'll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + ... documents avoidable days, and facilitates progression of care. Collaborates with Utilization Management staff for collaboration on patient status changes… more
    AdventHealth (01/21/25)
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