Top 8610 Rn Utilization Management Jobs

Care Manager (RN) - Discharge Planning
MaineHealth —Portland, ME
- Email
- Nursing
- RN License
- Hospital
- Paid parental leave
- Parental leave
Clinical Review and Appeals Specialist
Life Care Centers of America —Cleveland, TN
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- Health insurance
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RN Case Manager Acute Care
River Oaks Hospital and Clinics —Houston, TX
- $70,000 - $80,000 a year
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MDS Coordinator Part time
Brooklyn United Methodist Church Home —Brooklyn, NY
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- Free parking
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RN Case Manager, ED
Community Health System —Fresno, CA
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Utilization Management Nurse
Blue Eagle Consulting —Remote
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Utilization Management Nurse Consultant
CVS Health —Florida
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- Weekends as needed
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Utilization Management Nurse
Brighton Health Plan Solutions, LLC —Remote
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Quick Apply
2d
Utilization Management Outpatient Authorization Nurse
Champion Health Plan is a Medicare Advantage Prescription Drug HMO C-SNP serving Medicare beneficiaries with End-Stage Renal Disease. —Long Beach, CA
- From $67,000 a year
- Full-time
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RN Care Manager
MARYLAND PRIMARY CARE PHYSICIANS LLC —Glen Burnie, MD
- $93,000 - $98,000 a year
- Full-time
- Background check
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SENIOR ANALYST HEALTH HOME
SBH Health System —Bronx, NY
- $110,000 - $114,000 a year
- Full-time
- Background check
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Utilization Specialist
RiverWoods Behavioral Health —Riverdale, GA
- Part-time
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Director, Utilization Management & Operational Integrity
Medical Mutual of Ohio —Cleveland, OH
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- Health savings account
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Utilization Review Nurse (RN)
Lighthouse Care Center of Augusta —Augusta, GA
- Full-time
- Nursing
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- RN License
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TX, RN Certified Case Manager - Workers Compensation
The Reny Company —Dallas, TX
- $80,000 - $90,000 a year
- 8 hour shift
- Remote
- Nursing
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- Mileage reimbursement
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Utilization Review Coordinator
Neuropsychiatric Hospitals —Huber Heights, OH
- Full-time
- Nursing
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- Health insurance
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Clinical Utilization Management Coordinator (UM) $5k Sign-On
Smokey Point Behavioral Hospital —Marysville, WA
- $34 - $38 an hour
- Full-time
- Nursing
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8d
Utilization Management Nurse
TEXAS INDEPENDENCE HEALTH PLAN INC —Austin, TX
- Weekends as needed
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MDS Coordinator RN
Water's Edge at Port Jefferson for Rehabilitation and Nursing —Port Jefferson Station, NY
- Up to $140,000 a year
- Full-time
- Nursing
- Skilled nursing facility
- RN License
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1d
Utilization Review Nurse
Nora Concierge Care —Syracuse, NY
- $65 an hour
- Contract
- RN License
- BLS Certification
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Quick Apply
2h

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Care Manager (RN) - Discharge Planning

MaineHealth -
Portland, ME

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Job Details

Full-time

Benefits

Paid parental leave
Parental leave
Loan assistance

Qualifications

RN License
Customer service
Data management
Patient care
Insurance provider collaboration

Full Job Description

Description

Maine Medical Center

Nursing
Req #: 82644

This is a Clinical Nurse II vacancy open to candidates with greater than 1 year of RN work experience

This is a Bargaining Unit Position

2 Positions Available

Job Posting Date: 6/9/2026

FT/Days

The purpose of the Case Manager I position is to support the interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. This work is performed under general supervision in accordance with the Maine Medical Center (MMC) institutional policies and Care Management Department policies.

The Case Manager I is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources. Specific functions within this role include but are not limited to:

Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to address barriers to timely and efficient care delivery, flow and reimbursement
Application of process improvement methodologies in evaluating outcomes of care
Support and coaching of clinical documentation efforts
Coordinating communication with the interdisciplinary care team Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the patient served. Must demonstrate knowledge of the principles of growth and development as it relates to the different life cycles.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

Education: BSN or must matriculate into a BSN program within one year of hire and completion attained within 5 years of hire.
License/Certifications: Current and valid license to practice as a Registered Nurse in the state of Maine. Professional certification as a Case Manager preferred.
Experience: One to three years clinical experience in clinical practice area, three to five years preferred.
Excellent interpersonal communication and negotiation skills.
Strong analytical, data management and PC skills.
Working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement preferred.
Understanding of pre-acute and post-acute venues of care and post-acute community resources preferred.
Strong organizational and time management skills.
Ability to work independently and exercise sound judgment in interactions with interprofessional team, payors, and patients and their families.
Demonstrate commitment to organizational values.
Perform duties in a manner to promote quality patient care and customer service/satisfaction, while promoting safety, cost efficiency, and a commitment to the quality process.

Hiring Scam Alert

MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to [email protected].

Additional Information

With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the walls of the organization and the communities that surround it.

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow – programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.

MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you’re looking to build a career in a place where people help one another deliver best-in-class care, apply today.

If you have questions about this role, please contact [email protected]

Apply Now

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