Utilization Management RN jobs

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Five years of recent experience in a clinical health care setting with responsibilities reflecting direct management of patient care including planning,...
RN Care Manager – Utilization Review
Martin Luther King, Jr. Community Hospital - Los Angeles, CA
Certification in Case Management preferred. Reporting to the Manager of Care Management, the Care Manager of Utilization Review (UR) is responsible for managing...
Home Health RN Case Manager
Interim HealthCare of Columbus - Columbus, OH
Active Ohio RN License. Experience with an electronic medical record (EMR) system, and utilization of point of care device;...
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Elliot Hospital - 57 reviews - Manchester, NH
Knowledge of outcomes research, physician profiling, managed care quality mandates, case management, DRGs and coding principles and practices, statistics and...


Duke University and Duke University Health System - 22 reviews - Raleigh, NC
Complies with current rules and regulatory requirements pertaining to utilization management. Maintains effective communication with health care team members...

Onsite UM Nurse - Pensacola area

Humana - 1,956 reviews - Pensacola, FL 32504
Previous experience in utilization management, discharge planning and/or home health or rehab. Examine clinical programs information to identify members for...

Clinical Documentation Spec

Eastside Medical Center - Snellville - Snellville, GA
Utilization Review or Case Management Experience preferred. RN or RHIA preferred. Analyzes inpatient records for status of the patient, current treatment plan...


Premier Health Partners - 31 reviews - Dayton, OH
Certification in Clinical documentation, CPHQ, or Case Management preferred. Through utilization of their clinical expertise they ensure the patient’s severity...

Clinical Documentation Spec

Grady Health System - 140 reviews - Atlanta, GA 30303 (Five Points area)
Utilization Review, Care Management or coding experience preferred. Collaborates with interdisciplinary teams including, but not limited to, physicians, nurse...

Case Manager (RN)

Aetna - 1,664 reviews - Phoenix, AZ
-Identify complex, high-risk patients and proactively manage care including but not limited to care management planning, referral management, post-discharge...

CM Utiliz RN

Kaiser Permanente - 3,710 reviews - Riverside, CA
Completion of an accredited RN training program that allows graduates to take RN license exam. Current California RN license required....

Utilization Management RN: Remote

eQHealth Solutions - Baton Rouge, LA 70809
Works with Corporate IT management on projects as needed. Provides user-level support with applications necessary to carry out day-to-day tasks required to...

Supv Utilization Management

MedStar Health – Baltimore - 4 reviews - Washington, DC
2 years recent utilization review experience; Valid RN license in the District of Columbia. Responsible for clinical review of all acute services for...
Case Manager/Utilization Review (Relocation)
Provides input in such meetings regarding utilization management and discharge planning. The Case Manager is responsible for compliance with CMS Conditions of...
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RN Case Manager Hospice/Homecare
Visiting Nurse Association & Hospice of VT and NH - Randolph, VT
Payer source documentation, including management of authorizations; Appropriate treatment intervention, evaluation of outcomes, and utilization of services to...

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