Top 5130 Rn Utilization Manager Jobs

Director of Case Management / Utilization Review / Business Development
Hamilton Memorial Hospital District —Mc Leansboro, IL
- $35.00 - $50.40 an hour
- Full-time
- Background check
- Nursing
- Management
- Health insurance
- Dental insurance
Quick Apply
OR Manager
Green Mountain Surgery Center —Colchester, VT
- $90,000 - $120,000 a year
- No weekends
- Nursing
- Surgery
- RN License
- Free parking
- Health insurance
UM Case Manager
Havenwyck Hospital (UHS) —Auburn Hills, MI
- $60,000 - $69,000 a year
- Full-time
- Background check
- LMFT
- Nursing
- Loan repayment program
- Health insurance
Quick Apply
ASC Nurse Co-manager
Tri-State Gastroenterology —Crestview Hills, KY
- Full-time
- Background check
- Nursing
- RN License
- Free parking
- Profit sharing
Quick Apply
9d
(RN) Clinical Manager - ProHealth Home Health
ProHealth Home Health and Hospice —Auburn, AL
- Nursing
- Microsoft Outlook
- RN License
Quick Apply
11d
RN, Care Manager, Utilization Management (Part-time, Every weekend - Remote)
Adventist Health —Roseville, CA
- $59.23 - $81.24 an hour
- Part-time
- Remote
- Nursing
- RN License
- Mid-level
12d
Care Manager RN - Utilization Management (UM) Remote
Highmark Inc. —Pennsylvania
- $68,400 - $105,900 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
10d
RN Case Manager
Zócalo Health —Remote
- $85,000 a year
- Full-time
- Remote
- RN License
- Writing skills
- Mid-level
- Health insurance
- Dental insurance
9d
Utilization Management Registered Nurse
Humana —Florida
- $71,100 - $97,800 a year
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Paid holidays
Clinical Field Manager
SEV Laser Aesthetics —Los Gatos, CA
- $100,000 - $110,000 a year
- Weekends as needed
- Mid-level
- Travel
- Ability to stand for extended periods
Quick Apply
Clinical Field Manager
SEV Laser Aesthetics —San Francisco, CA
- $100,000 - $110,000 a year
- Weekends as needed
- Mid-level
- Travel
- Ability to stand for extended periods
Quick Apply
Clinical Field Manager
SEV Laser Aesthetics —San Rafael, CA
- $100,000 - $110,000 a year
- Weekends as needed
- Mid-level
- Travel
- Ability to stand for extended periods
Quick Apply
TOP Case Management Program Manager
International SOS —San Antonio, TX
- Background check
- Nursing
- RN License
Quick Apply
Case Management Nurse - Oncology or Transplant Experience
Innovative Care Management, Inc. —Arizona
- Full-time
- Remote
- Background check
- Nursing
- RN License
- Health insurance
5d
Clinical Coordinator
ALLERGY PARTNERS —Winchester, VA
- Email
- RN License
- 5 years
- HIPAA
- Health savings account
- Paid holidays
Quick Apply
5d
Case Management Nurse - Oncology or Transplant Experience
Innovative Care Management, Inc. —Idaho
- Full-time
- Remote
- Nursing
- RN License
- 5 years
- Health insurance
5d
Clinical Field Manager
SEV Laser Aesthetics —Sunnyvale, CA
- $100,000 - $110,000 a year
- Weekends as needed
- Mid-level
- Travel
- Ability to stand for extended periods
Quick Apply
Utilization Review Nurse
HAMASPIK CHOICE INC —Spring Valley, NY
- $45 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Registered Nurse - Utilization Management
Luke Staffing —Goldsboro, NC
- $31.91 an hour
- Monday to Friday
- Nursing
- Current TB test
- RN License
Quick Apply
Staff Nurse - Case Manager
Skagit Regional Health —Mount Vernon, WA
- $40.54 - $73.92 an hour
- Full-time
- Nursing
- RN License
- Hospital
- Disability insurance
- Health insurance
Quick Apply

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Director of Case Management / Utilization Review / Business Development

Hamilton Memorial Hospital District
Mc Leansboro, IL

Quick Apply

Job Details

Full-time
$35.00 - $50.40 an hour

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
Flexible schedule
Life insurance
Referral program
Retirement plan

Qualifications

Teamwork
RN License
Bachelor of Science
Managing patients as a nurse case manager
Driver's License
Bachelor of Science in Nursing
Hospital experience
Stakeholder relationship building

Full Job Description

Company Overview:
Hamilton Memorial Hospital District (HMHD) has been serving its community for over 60 years. As a 25-bed critical access facility staffed by skilled medical professionals, HMHD is dedicated to providing comprehensive, patient-focused care utilizing state-of-the-art technology. The hospital is committed to delivering modern, convenient, and affordable healthcare close to home.

About the Position:
Hamilton Memorial Hospital District is seeking an experienced and motivated Director of Case Management / Utilization Review / Business Development to join our leadership team. This position plays a vital role in ensuring high-quality, patient-centered care by providing leadership in case management, utilization review, discharge planning, resource management, and strategic business development.

The Director works collaboratively with physicians, clinical staff, payors, post-acute providers, and community partners to promote appropriate utilization of healthcare services, successful care transitions, regulatory compliance, and positive patient outcomes. This position also serves as a key ambassador for the organization by developing referral relationships, educating healthcare partners about our services, and supporting initiatives that increase patient access and organizational growth.

Wage Range: $35.00- $50.40

Benefits:

Competitive pay based on experience and education
Set, flexible schedule
Free CEUs for licensing
Excellent benefits package. View here: https://hmhospital.org/career_benefits/

Position Highlights:

Full-time leadership position
Primarily scheduled Monday through Friday; however, occasional after-hours communication may be necessary to facilitate patient placement, utilization review, discharge planning, or swing bed referral opportunities.
Reports to the Chief Nursing Officer/Chief Clinical Officer
Opportunity to make a meaningful impact on patient care, operational excellence, and community outreach

Essential Responsibilities:

Lead the hospital's case management, utilization review, discharge planning, and resource management programs.
Ensure compliance with CMS Conditions of Participation (CoPs), accreditation standards, and applicable regulatory requirements.
Develop and implement safe, patient-centered discharge plans and coordinate transitions of care.
Identify barriers to discharge and opportunities to reduce length of stay and prevent avoidable readmissions.
Oversee utilization review processes for inpatient, emergency department, and swing bed patients.
Collaborate with physicians, interdisciplinary teams, payors, and post-acute providers to ensure appropriate utilization and reimbursement.
Facilitate multidisciplinary care coordination meetings.
Build and strengthen referral relationships with physicians, healthcare organizations, and community partners.
Educate providers, case managers, and community members about hospital services and specialty programs.
Participate in community outreach activities and business development initiatives.
Support quality improvement efforts and organizational strategic goals.

Qualifications:

Current Illinois Registered Nurse (RN) license required.
Bachelor of Science in Nursing (BSN) preferred.
Experience in case management and discharge planning required.
Working knowledge of insurance processes and government reimbursement programs.
Critical Access Hospital experience preferred.
Valid driver's license, reliable transportation, and current auto liability insurance required.

Ideal Candidate:

We're looking for a collaborative healthcare leader who demonstrates:

Strong leadership, organizational, and problem-solving skills
Excellent communication and relationship-building abilities
Knowledge of utilization review, case management, reimbursement, and regulatory requirements
A commitment to quality improvement, patient safety, and exceptional patient care
The ability to manage multiple priorities in a fast-paced healthcare environment

If you're passionate about improving patient outcomes while helping shape the future of healthcare in our community, we'd love to hear from you.

Apply today and become part of the Hamilton Memorial Hospital District team dedicated to providing compassionate, high-quality care close to home.

Pay: $35.00 - $50.40 per hour

Benefits:

Dental insurance
Health insurance
Life insurance
Paid time off
Referral program
Retirement plan
Vision insurance

License/Certification:

RN License (Required)

Work Location: In person

Quick Apply

Refine Your Search

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