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Keywords: Registered Nurse - Utilization Management, Location: USA

Page: 5

Clinical Evaluation Manager, Utilization Management

and updates through on-going training, coaching and educational materials. For Utilization Management Only: Issues... or federal regulations are saved in the Utilization Management System. Reviews, evaluates and determines the appropriateness...

Location: New York City, NY
Posted Date: 20 Sep 2025
Salary: $85000 per year

Utilization Management RN-Hometown Health

Position Purpose This position consistently applies the utilization management process as required by CMS including... the use of designated criteria for primary review. Incorporates into the utilization management process the ability...

Company: Renown Health
Location: Reno, NV
Posted Date: 20 Sep 2025

Clinical Evaluation Manager, Utilization Management

and updates through on-going training, coaching and educational materials. For Utilization Management Only: Issues... or federal regulations are saved in the Utilization Management System. Reviews, evaluates and determines the appropriateness...

Location: New York City, NY
Posted Date: 19 Sep 2025
Salary: $85000 per year

Utilization Management Specialist

necessity, and documentation improvement. QUALIFICATIONS 1. Registered Nurse. 2. 3 years in an acute care setting..., utilization management, or insurance/hospital case management setting. 3. Knowledge of InterQual criteria. 4. Attends...

Location: Ohio
Posted Date: 19 Sep 2025

RN-Utilization Management

Overview: ERP International is seeking a Registered Nurse (RN) for a Full-Time position in Utilization Management... technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states. Founded in 2006, ERP...

Posted Date: 18 Sep 2025

Behavioral Health Utilization Management Clinician - Tues to Sat Shift- Remote VA and NC

Sentara Health is seeking to hire a qualified individual to join our team as a Behavioral Health Utilization Management... - 9:00AM Overview Behavioral Health Utilization Management Clinician is responsible for review of clinical information...

Company: Sentara Health
Location: Norfolk, VA
Posted Date: 18 Sep 2025
Salary: $58572.8 - 97635.2 per year

Behavioral Health Utilization Management Clinician - Remote VA and NC

Sentara Health is seeking to hire a qualified individual to join our team as a Behavioral Health Utilization Management... Behavioral Health Utilization Management Clinician is responsible for review of clinical information received from providers...

Company: Sentara Health
Location: Norfolk, VA
Posted Date: 18 Sep 2025
Salary: $58572.8 - 97635.2 per year

Clinical Evaluation Manager, Utilization Management

. For Utilization Management Only: • Issues Determinations, Notices of Action, and other forms of communication to members and providers..., and other communications required by state or federal regulations are saved in the Utilization Management System. Reviews, evaluates...

Location: New York City, NY
Posted Date: 18 Sep 2025
Salary: $85000 per year

Supervisor, Utilization Management

Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management... Collaborates with utilization management team to resolve complex care member issues Maintains knowledge of regulations...

Company: Centene
Location: USA
Posted Date: 17 Sep 2025
Salary: $73800 - 132700 per year

Medical Director, Utilization Management - FEP

utilization management position that has core responsibilities in the areas of inpatient concurrent review, pre and post service... and support for the prior authorization registered nurse (RN) team, facilitating appropriate use of resources, including safe...

Posted Date: 14 Sep 2025

Senior Manager, Behavioral Health Utilization Management

care to members. Oversees and works with senior leadership on utilization management issues related to member care..., provider interactions, and facilitates operations within utilization management. Oversees the behavioral health (BH...

Company: Centene
Location: USA
Posted Date: 14 Sep 2025
Salary: $100900 - 186800 per year

Behavioral Health Utilization Management Care Coordinator (LCSW/LPC/LMFT/RN) - Remote in VA and NC

Sentara Health Plans is hiring a Behavioral Health Utilization Management Care Coordinator (LCSW/LPC/LMFT/RN) remotely.... Job Description Summary: Behavioral Health Utilization Management clinician is responsible for review of clinical information received...

Company: Sentara Health
Location: Norfolk, VA
Posted Date: 12 Sep 2025
Salary: $58572.8 - 97635.2 per year

Lead Utilization Management Coordinator

Management Lead supports the daily operations of utilization review activities, ensuring timely and accurate documentation... required. Registered nurse licensure or licensed as an LMSW, LCSW, LPC, MFT or similar AZ Board of Behavioral Health licensure preferred...

Location: Scottsdale, AZ
Posted Date: 11 Sep 2025

Executive RN Director of Utilization Management and CDI

RN Executive Director of Utilization Management and CDI Gainesville, GA As the Executive Director of Utilization... Utilization Management and Clinical Documentation Integrity to ensure accurate documentation, appropriate resource use...

Posted Date: 08 Sep 2025

RN Utilization Management Concurrent Review

utilization management to patients, families, and other members of the care team as needed. Maintains current knowledge of health... and Certifications Registered Nurse (RN) - Virginia Department of Health Professions (VDHP) (Required) Certified Case Manager (CCM...

Posted Date: 05 Sep 2025

Care Coordinator, Utilization Management

management. Licenses and Certifications Required: NJ State Professional Registered Nurse License. AHA Basic Health Care Life... as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team...

Posted Date: 05 Sep 2025
Salary: $90750.4 per year

Care Coordinator, Utilization Management

management. Licenses and Certifications Required: NJ State Professional Registered Nurse License. AHA Basic Health Care Life... as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team...

Posted Date: 04 Sep 2025
Salary: $90750.4 per year

Care Coordinator, Utilization Management

management. Licenses and Certifications Required: NJ State Professional Registered Nurse License. AHA Basic Health Care Life... as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team...

Posted Date: 31 Aug 2025
Salary: $90750.4 per year

Director of Case Management - Utilization Management

Management Team consisting of Registered Nurses, Social Workers, and Clinical Coordinators. This leader will oversee all facets... of utilization management, discharge planning, and care coordination to ensure patiens receive timely, appropriate, and efficient...

Company: Prime Healthcare
Location: Inglewood, CA
Posted Date: 28 Aug 2025
Salary: $108160 - 163800 per year

Director of Case Management - Utilization Management

Case Management Team consisting of Registered Nurses, Social Workers, and Clinical Coordinators. This leader will oversee... all facets of utilization management, discharge planning, and care coordination to ensure patiens receive timely, appropriate...

Posted Date: 28 Aug 2025
Salary: $108160 - 163800 per year