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Keywords: RN Utilization Review, Location: USA

Page: 13

Clinical Medical Review Nurse

management, discharge planning or utilization review experience. Licenses/Certifications: RN - Registered Nurse - State.... We are in search of a highly motivated candidate to join our talented Team. Job Title: Clinical Medical Review Nurse. Location...

Company: Ampcus
Location: Baltimore, MD
Posted Date: 10 Jan 2026

Medical Management - Medical Review Examiner Nurse 145

plan clinical operations (for example utilization review, quality improvement, clinical claims review). Experience...JOB SUMMARY: The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying...

Company: CommunityCare
Location: Tulsa, OK
Posted Date: 10 Jan 2026

Nurse Reviewer - Clinical Review Unit

. Settings include inpatient, outpatient, in-state, out-of state and out-of country. Document clinical case summary and review... outcome of each review appropriately to meet regulatory and program requirements. Review various types of services, including...

Posted Date: 02 Jan 2026

Vice President, Bill Review and Managed Care

including utilization review and case management functions. Ensure compliance of MPN with our business partner, design, develop... of the position will be to differentiate the PRIME program in the marketplace; manage bill review and the nurse case managers...

Company: Gallagher
Location: Torrance, CA
Posted Date: 23 Dec 2025

Vice President, Bill Review and Managed Care

managers including utilization review and case management functions. Ensure compliance of MPN with our business partner, design... functions of the position will be to differentiate the PRIME program in the marketplace; manage bill review and the nurse case...

Company: AssuredPartners
Location: Torrance, CA
Posted Date: 19 Dec 2025

Medical Review Director - CGS Administrators, LLC

's in a job related field. Required Experience: 5 years healthcare program management, utilization/case management, or medical review... to make business decision. Knowledge/understanding of utilization review guidelines, managed care delivery systems...

Posted Date: 06 Dec 2025

Clinical Review Nurse - Concurrent Review - J00933

and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: LPN... - Licensed Practical Nurse - State Licensure required RN license required Responsibilities Performs concurrent reviews...

Company: BravoTech
Location: Corpus Christi, TX
Posted Date: 25 Oct 2025

Registered Nurse-Review Analyst

Job Description: This position will be remote role for Nurses in Michigan Should have a valid MI RN License... Should Have utilization management experience. Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing...

Company: LanceSoft
Location: Detroit, MI
Posted Date: 16 Dec 2025

RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre)

Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre) Location: Wilkes-Barre..., Pennsylvania Job Category: Inpatient RN - Registered Nurse, Nursing and Nursing Support Schedule: Rotation Work Type: Full time...

Company: Geisinger
Location: Wilkes-Barre, PA
Posted Date: 23 Jan 2026

RN - Graduate Registered Nurse (Geisinger South Wilkes-Barre)

Job Title: RN - Graduate Registered Nurse (Geisinger South Wilkes-Barre) Location: Wilkes-Barre, Pennsylvania... Job Category: Inpatient RN - Registered Nurse, Nursing and Nursing Support Schedule: Rotation Work Type: Full time Department...

Company: Geisinger
Location: Wilkes-Barre, PA
Posted Date: 23 Jan 2026

RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton)

Job Title: RN - Graduate Registered Nurse (Geisinger Community Medical Center, Scranton) Location: Scranton..., Pennsylvania Job Category: Inpatient RN - Registered Nurse, Nursing and Nursing Support Schedule: Rotation Work Type: Full time...

Company: Geisinger
Location: Scranton, PA
Posted Date: 23 Jan 2026
Salary: $21000 per year

Care Manager Lead (RN) : Care Management

on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May... Certification in Utilization Review, Care Management, or Clinical Nursing preferred. Additional requirements for specific...

Company: Hoag
Location: Newport Beach, CA
Posted Date: 23 Jan 2026

Nurse Case Manager (RN)

to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift, and mid shift Job types... position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged...

Location: Silver Creek, GA
Posted Date: 23 Jan 2026
Salary: $59030 - 77630 per year

RN Care Manager - Exempt

as needed. Actively participates in utilization review meetings and quality improvement projects / meetings. Evaluates the competence... SUMMARY: The RN Care Manager is responsible for assessing the care needs of participants, provides nursing and healthcare...

Company: BoldAge PACE
Location: Columbus, OH
Posted Date: 23 Jan 2026

Nurse Case Manager (RN)

to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift, and mid shift Job types... following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged...

Location: Grand Blanc, MI
Posted Date: 23 Jan 2026
Salary: $72470 - 111200 per year

RN - Inpatient Case Manager (Days), Jefferson

including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria... utilization. Serves as key team members in the management of readmissions, length of stay, ED utilization, and patient/family...

Company: Highmark Health
Location: USA
Posted Date: 23 Jan 2026

RN Inpatient - Adult Acute Care - Transplant Unit - 2 South (PRN)

on between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties.... Please review the following instructions prior to submitting your job application: Provide all of your employment history...

Posted Date: 23 Jan 2026

Registered Nurse (RN) - Griffin Cardiovascular Part Time

States of America) Job Summary: The RN Clinical Nurse is a proactive member of an interdisciplinary team of licensed... Professional Practice Model, 5-Star Nursing and evidence based practice and research. RN competencies are derived from these models...

Location: Jasper, GA
Posted Date: 23 Jan 2026

ASC RN Specialty

team, and The Power of Every One. Job Title ASC RN Specialty Location Coral Springs Facility Coral Springs FHC... guidelines and hospital policies and procedures. As an ASC RN supporting Endoscopy and PACU, you will use your strong assessment...

Company: Cleveland Clinic
Location: Coral Springs, FL
Posted Date: 23 Jan 2026

RN - General Surgery Operating Room

States of America) Job Summary: Periop RN - Outpatient Surgery Center Circulating RN - Main OR Core Responsibilities..., but is not limited to diverse and inclusive interdisciplinary communication methods (interdisciplinary rounds, case review...

Location: Roswell, GA
Posted Date: 23 Jan 2026