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Utilization Management RN Jobs

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  • 2.3
    Brown & Toland Physicians – Oakland, CA
    Est. Salary $106k-$162k
    9 days ago 9d
    industry. Provides education to Care Management, Quality Management and Utilization management industry wide activities. Prepares… POSITION SUMMARY: The Manager, Care Management - Utilization Management is a member of the senior leadership team of the Medical…
  • 3.3
    Quantum Health – Columbus, OH
    Est. Salary $56k-$78k
    23 days ago 23d
    Job Title: Utilization Management Nurse (RN) Working Group: Clinical Services Reports to: POD Manager Quantum… time to join our winning culture! We are looking for a Utilization Management Nurse. Roles and Tasks: Promote the mission…
  • 3.2
    L.A. Care – Los Angeles, CA
    Est. Salary $81k-$106k
    10 days ago 10d
    years of clinical RN experience particularly in review of inpatient or sub-acute admissions Utilization Management experience at HMO… Previous experience in Case management, utilization management/ ambulatory case management or disease management. Strong clinical skills…
  • 3.6
    Baylor Scott & White Health – Temple, TX
    Est. Salary $53k-$70k
    1 days ago 1d
    The Utilization Review Registered Nurse (RN) is responsible for daily oversight of the utilization review (UR) department. The… The Utilization Review RN will provide direct assistance to the UR Managers, as well as direction for complex cases, monitors pending…
  • 4.4
    Central California Alliance for Health – Merced, CA
    Est. Salary $64k-$130k
    24 days ago 24d
    Registered Nurse and a minimum of three (3) years of utilization management experience and some supervisory or team leadership experience… Working knowledge of the principles and practices of utilization management; Working knowledge of and proficiency with Windows…
  • 3.2
    Sanford Health – Sioux Falls, SD
    Est. Salary $46k-$59k
    3 days ago 3d
    Job Title: RN Utilization Management Specialist | Utilization Management | Sioux Falls City: Sioux Falls State:… JOB SUMMARY Performs utilization management activities in accordance with Utilization Management Plan to assure compliance…
  • 3.6
    Presbyterian Healthcare Services – Albuquerque, NM
    13 days ago 13d
    LTC UTILIZATION MANAGEMENT REVIEWER - FULL TIME (1 FTE) - DAYS (Job ID: 7654) Type of Opportunity: Full Time FTE: 1.000000… plan insurance environment , with expertise performing utilization management or experience working in long term care services Knowledge…
  • 3.5
    Arcadia Healthcare Solutions – Rockford, IL
    14 days ago 14d
    Responsibilities: • Performs telephonic utilization review services in compliance with federal and state regulations… services covered under the Arcadia Clinical Services department • Utilize and document the appropriate medical criteria used to make…
  • 3.2
    MemorialCare Health System – Fountain Valley, CA
    Est. Salary $66k-$88k
    16 days ago 16d
    meet the patients' physical, emotional, and spiritual needs. The RN Case Manager uses a problem-solving process that includes assessment… experience preferred. Education: Current California RN license Current AHA BLS for Healthcare Providers card…
  • 4.0
    Riverside Healthcare – Kankakee, IL
    14 days ago 14d
    Requirements: Current RN license in the state of Illinois Certification as a Certified Professional Utilization Review (CPUM) or Certified… Certified Professional Utilization Management (CPUR) preferred within 3 years of employment…
  • 3.4
    MultiCare Health System – Tacoma, WA
    13 days ago 13d
    Position Summary: The Utilization Review (UR) Specialist is responsible for concurrent utilization management activities to a defined… of staff and management. Minimum Requirements: Five years of clinical experience required; utilization management and/or insurance…
  • 4.4
    Central California Alliance for Health – Merced, CA
    Est. Salary $48k-$97k
    19 days ago 19d
    efficiency; and Reporting regularly and timely to Utilization Management and other Health Services Directors and Managers regarding… providers; Participating as a team member in Alliance Utilization Management Department trainings, activities, and projects; Advising…
  • 3.3
    Aerotek – Austin, TX
    Est. Salary $48k-$62k
    2 days ago 2d
    insure that proper care is being utilized.Perform utilization management, utilization review, and/or concurrent review. This role communicates… quality assurance/risk management concerns. Thoroughly document all activity in the utilization/case management documentation system…
  • 3.2
    MemorialCare Health System – Laguna Hills, CA
    Est. Salary $38k-$57k
    10 days ago 10d
    is preferred. RN License required. Current BLS for Healthcare Providers Certification. Case Management Certificate or Certification… Pulmonary Disease. Position Summary: The Registered Nurse (RN) Case Manager collaborates with other professional disciplines…
  • 2.5
    FirstCare Health Plans – Lubbock, TX
    Est. Salary $46k-$63k
    6 days ago 6d
    Requisition Number 16-0133 Post Date 11/7/2016 Title Utilization Management Nurse City Lubbock State TX Description SUMMARY… RESPONSIBILITIES: •Maintains current knowledge of approved utilization management criteria and guidelines as well as Evidence of Coverage…
  • 4.4
    Central California Alliance for Health – Scotts Valley, CA
    Est. Salary $57k-$79k
    12 days ago 12d
    Coordinator and UM Case Management RNs by sharing their expertise; Consulting/coordinating with the Care Management Team, County Social… in the UM Case Management programs by reaching out to Primary Care Providers, specialists, Hospital, Utilization Review, Social…
  • 3.6
    Evolent Health – Indianapolis, IN
    Est. Salary $63k-$81k
    5 days ago 5d
    information in medical management system. Performs Telephonic prospective, concurrent and retrospective utilization reviews. Use effective… appropriate consultation and referral to Care Management personnel. Guides members into utilization of contracted physicians, facilities…
  • 3.2
    Sanford Health – Sioux Falls, SD
    Est. Salary $46k-$59k
    19 days ago 19d
    Job Title: RN Utilization Management Specialist | Sanford Health Plan | Sioux Falls City: Sioux Falls State: South… JOB SUMMARY Performs utilization management activities in accordance with Utilization Management Plan to assure compliance…
  • 3.3
    The Reading Hospital and Medical Center – West Reading, PA
    Est. Salary $60k-$81k
    3 days ago 3d
    Manager promotes quality of care, supports effective resource utilization, and facilitates the patients progression of care to proactively… of provider based case management experience preferred Payer or community-based Case Management experience will be considered…
  • 2.6
    WellMed Medical Management – Eden Prairie, MN
    Est. Salary $66k-$87k
    4 days ago 4d
    Global.TextThisJob Utilization Management RN - Telecommute - 714968 Global.ApplyNow Global.ApplyNow… employment. Job Keywords: Keywords: RN, registered nurse, utilization, case management, discharge planning, MD, telephonic, telecommute…
  • 2.8
    Valence Health – Chicago, IL
    Est. Salary $61k-$75k
    2 days ago 2d
    Additional Functions: Functions as the key contact and utilization management expert for a client, business line, or product. Duties… coordination of discharge planning. Tasks are performed within the RN scope of practice, under Medical Director direction, using independent…
  • ProEnlist – Dallas, TX
    EASY APPLY
    Est. Salary $58k-$91k
    2 days ago 2d
    Manager, Utilization Management - RN Joining this team means you'll be surrounded by colleagues who are dedicated to meeting… regarding medical utilization management functions. Develop, implement, and maintain utilization management programs to facilitate…
  • 3.2
    UnitedHealth Group – Cypress, CA
    Est. Salary $69k-$95k
    3 days ago 3d
    Care Manager you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with… organization, anywhere. Primary Responsibilities: Perform utilization and concurrent review of inpatient cases using Milliman criteria…
  • 2.5
    Ellis Hospital – Schenectady, NY
    Est. Salary $47k-$60k
    5 days ago 5d
    Registered Nurse Utilization Management RN Ellis Hospital | Nott Street, Schenectady, NY Case Management Days, Full-Time 72… UM RN is responsible for preoperative, concurrent and retrospective reviews in accordance with the utilization management program…
  • ProEnlist – Honolulu, HI
    EASY APPLY
    Est. Salary $113k-$173k
    1 days ago 1d
    Director Utilization Management (RN) Job Description: Responsible for all aspects of utilization management, care coordination… identify and resolve utilization management issues of strategic importance to the Hawaii Region. Evaluates utilization reviews and determines…
  • 2.7
    Centers Plan for Healthy Living – Staten Island, NY
    Est. Salary $56k-$74k
    5 days ago 5d
    Required: Active and unrestricted NYS RN license Minimum 2 years utilization management experience Strong written and verbal… Overview: � Utilization Management Registered Nurse The Utilization Management nurse works within a multidisciplinary…
  • The Grey Group – Firth, ID
    Est. Salary $43k-$59k
    2 days ago 2d
    RN Utilization Management Nurse needed. This position is located in nearby Pocatello, ID. Registered Nurse to function as our… our Data Abstractor / Quality Utilization Management Nurse. Multiple Shifts and RN Specialties available. Apply to be considered…
  • 3.4
    University Hospitals – Toledo, OH
    Est. Salary $53k-$67k
    13 days ago 13d
    an accredited nursing program License Requirements: * Current RN licensure in the State of Ohio Preferred Qualifications: * Bachelor's… and adherence to regulatory requirements associated with utilization * Support for inappropriate level of care and decreased inpatient…
  • 2.9
    Healthfirst (New York) – New York, NY
    Est. Salary $77k-$101k
    2 days ago 2d
    health care services Utilizes ICD9-CM and CPT codes for data entry into Utilization Management/Case Management (UM/CM) system.… Qualifications: Associate's degree in Nursing with Registered Nurse (RN) License. Clinical work experience. Work experience using…
  • 3.6
    Evolent Health – Baltimore, MD
    Est. Salary $74k-$94k
    3 days ago 3d
    has case management and utilization management experience to join our population health team as a Utilization Management On-Site… Nursing 3-5 years of nursing experience doing utilization management and care management in a managed care environment. Current Registered…
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