Senior RN Case Management Lead - Utilization Review
Surgery Partners, Inc.
Manager of Case Management at Surgery Partners, Inc. leads the case management team with a strong focus on utilization review, ensuring compliant care and reducing unnecessary hospital stays. This role collaborates across departments to optimize care coordination and outcomes. Requirements include RN license with BSN, UR/UR-related credentials, and 3+ years hospital-based case management experience. Proficiency with EPIC and payer policies is preferred; leadership and communication skills are #J-18808-Ljbffr Surgery Partners, Inc.
- Beyond Blue is seeking a Supervisor, Utilization Review to lead the daily operations of the utilization review team in the UK. The role ensures compliance with payer guidelines and regulatory standards while guiding staff performance and quality assurance. Responsibilities...Suggested
$110k
...Nyack, New York Department: Care Management Work Shift: Day Work Days:... ...and with the most efficient utilization of resources. Carries out activities... ...for justification. Reviews the patient’s plan of care in... ...Improvement activities in the Case Management Department, making...SuggestedDaily paidFull timePart timeFlexible hoursShift work$2,868 per week
...Prime Staffing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in New York City, New York. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 09/21/2026 ~ Duration: 8 weeks...SuggestedPermanent employmentTemporary workZero hours contractShift work- MarinHealth is seeking a Utilization Review Nurse II to perform admission, concurrent and retrospective reviews for designated health plans... ..., 3+ years of acute care experience, and experience with case management software and Electronic Health Records. In this role you...Suggested
- Carson Valley Health in Nevada seeks a Per Diem Utilization Review RN to perform clinically oriented medical chart reviews and support the... ...Requirements include Nevada RN licensure, at least 1 year in case management/UR, CCM preferred, and knowledge of InterQual/McKesson...SuggestedHourly payDaily paid
$77.02k - $117.58k
...Bay Times’ Top Workplaces. Summary The Utilization Review Nurse is responsible for performing... ...appeal outcomes through collaboration with Case Management, Physician Advisors, providers, and... ...Minimum Licensure: Registered Nurse (RN) Minimum Licensure (Other): Knowledge...Full timeWork at office- ...clinically orientated medical chart reviews and other administrative... ...of the medical center's utilization review plan, state and federal... ...CCM (certification in case management) is preferred. License Required... ...TEAM!! Utilization Review RN - Per Diem* *IMPORTANT NOTE...Hourly payDaily paidWork experience placement
- Sentara Norfolk General Hospital in Norfolk, VA is hiring a Senior Inpatient Case Manager RN for a full-time weekend dayshift. This role leads inpatient case management operations, coordinates patient care, drives quality initiatives, and supports service excellence across...SeniorFull timeShift workWeekend workDay shift
- INTEGRIS Baptist Medical Center in Oklahoma City, OK is seeking a day shift/variable, full-time RN Case Manager - Utilization Review. You will assess patients, coordinate transfers, and develop discharge plans to optimize resources and patient outcomes. Qualifications...Full timeDay shift
$66.83k - $111.38k
..., Wyoming. Job Responsibilities Utilization Review Nurse is responsible for utilizing management services within the scope of licensure... ...of care coordinator with case management and facilitates member... ...Certification/Licensure: Registered Nurse (RN) License (Compact or Virginia)...Permanent employmentFull timeTemporary workRemote workShift workDay shift- ...Moffitt Cancer Center in Tampa, FL seeks an Utilization Review Nurse to perform initial, concurrent,... ...levels. You will collaborate with case management, physician advisers, providers, and... ...an Associate's Degree in Nursing with RN licensure; a Bachelor's in Nursing is...
- ...Summary We are seeking an experienced Registered Nurse (RN) - Utilization Review to evaluate the medical necessity, appropriateness, and... ...medical guidelines, and collaborate with physicians, case managers, health plans, and other healthcare professionals to ensure...
- The Utilization Review Nurse gathers demographic and clinical information... ...supporting the goals of the Case Management department and of CorVel.... ...state of operation required;RN is required unless local state... ...leveled roles (I, II, III, Senior, Lead, etc.) new hires may be...Minimum wageWork at officeLocal areaRemote workFlexible hours
- ## Utilization Review NurseApplyremote type: Hybridlocations: 1301 6th Ave W - BRADENTON, FLposted on: Posted Todayjob requisition id:... ...process-driven environment. Experience in utilization review or case management is highly beneficial, particularly within workers'...Work at officeImmediate startRemote workFlexible hours2 days per week
- ...Medical Service Association is seeking a Concurrent Nurse Reviewer for the Facility Utilization Review Unit. The role requires applying clinical and... ..., you will coordinate with medical directors, case management, and other teams, ensuring accurate documentation and...
- ...Community Care is looking to hire a Utilization Review Nurse. The Utilization Review... ...is responsible for utilization management services within the scope of... ...Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA...Temporary workRemote workShift work
$77.08k - $119.47k
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full... ...requisition id: 71163Department/Unit:Care Management/Social WorkWork Shift:Day (United... ...continuous improvement in both areas. • Refers cases and issues to Medical Director and...Shift work- Huntington Bancshares, Inc. is seeking a Credit Review Team Leader Sr. to guide a risk-focused... ...Director and drives independent risk management within the bank and its affiliates. The... ..., and stakeholder engagement across senior management and the #J-18808-Ljbffr Huntington...Senior
- ...Care Mgmt Clinician, Senior (RN Compact state license... ...Behavioral Health Care Management Clinician, Senior helps... ...Work Collaborate with case managers and other team... .... Interacts with Utilization department and Physician... ...change with periodic reviews. Physical Requirements...SeniorFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
$25 - $31 per hour
...empower people to lead healthier lives. Ready... ...moment where your review decides what... ...what keep the entire utilization review process... ...Escalate the right cases: Route denial authorizations... ...advance review or senior care consultants.... ...level of care. Manage the appeals...Hourly payMonday to Friday- KPFF Consulting Engineers seeks a SUE Lead in Los Angeles to manage field crews, locate and map underground utilities, and ensure ASCE 38-22 compliance. You will lead operations, mentor junior staff, and coordinate with project managers to deliver accurate documentation...Senior
- KODE Labs is seeking a Utility & Sustainability Solutions Lead to support the implementation and delivery of utility management, energy analytics, sustainability, and financial management solutions for enterprise real estate clients. This role combines subject-matter expertise...Senior
$2,883.5 per month
...Hospitals Corporation-Rikers Island Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 19030015 Job Title RN - Utilization Review Weekly Pay $2883.5...Weekly payShift work$2,749.5 per month
...Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 35546746 Job Title RN - Utilization Review (000298) Weekly Pay $2749.5 Shift Details Shift Day -...Weekly payShift work- ...Job Title: RN - Utilization Review (000298) Keywords: Number of Positions: 1 Remaining Positions: 1 Duties: 1 year of non-acute utilization review experience - required RN experience - preferred This is the pay range that RightSourcing (a part of Magnit) reasonably expects...
$2,940.02 per month
...HHC Correctional Health Services Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 19018147 Job Title RN - Utilization Review (000298) Weekly Pay $2940.02...Weekly payShift workDay shift- ...Skills: ~1 year of non-acute utilization review experience - required ~ RN experience - preferred Certification: New York State RN License Primary Source Verification AHA BLS Shift: ~8:30 AM-5:00 PM ~42.50 houris/week...Shift work
$55 - $65 per hour
...Registered Nurse With Utilization Review Experience A healthcare organization... ...an active New York State RN license. The ideal candidate... ...established utilization management criteria, policies, and clinical... ...team members regarding cases under review. Qualifications...Hourly payContract work- UCLA Health is seeking a Senior Case Manager in the Patient Navigation and Business Services team to coordinate care for international patients. You will review referrals, assess medical records, and arrange MD-to-MD case reviews with doctors abroad and locally to ensure...Senior
- RN - Utilization Review Shift: 5 Day Shifts X 8 Hrs Start Date: 09/14/2026 End Date: 11/07/2026 Duration: 8 Week(s) City: East Elmhurst State: NY TALENTShift workDay shift
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