Top 4019 Rn Utilization Review Jobs

RN Director of Care Management - Sign-On Bonus Eligible
Merit Health River Region —Vicksburg, MS
- Full-time
- Nursing
- RN License
- Hospital
- Relocation assistance
- Health insurance
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MDS Coordinator, RN
Confidential —Spartanburg, SC
- Full-time
- Background check
- Anatomy knowledge
- Skilled nursing facility
- Free parking
- Disability insurance
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RN Utilization Management - Nights onsite
CHRISTUS Health (IHE/Hosted) —Corpus Christi, TX
- $31.70 - $47.00 an hour
- Full-time
- Background check
- Master of Social Work
- Nursing
- Health savings account
- Relocation assistance
Quick Apply
Utilization Review Coordinator (RN or MSW)
Cumberland Hall Hospital —Hopkinsville, KY
- $30.86 - $46.28 an hour
- Full-time
- Acute care
- Master of Social Work
- Nursing
- Free parking
- Health savings account
Quick Apply
2d
RN Case Manager Acute Care
River Oaks Hospital and Clinics —Houston, TX
- $70,000 - $80,000 a year
- Full-time
- Background check
- Spanish
- Nursing
- Disability insurance
- Health insurance
Quick Apply
10d
Utilization Review RN
Providence Health and Services —Portland, OR
- $50.14 - $77.83 an hour
- Part-time
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Paid holidays
RN Utilization Management
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
- Vision insurance
Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!
MJHS —New York, NY
- $90,000 - $110,000 a year
- Microsoft Word
- Nursing
- RN License
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10d
Utilization Review Coordinator
Prosperous Health —Los Angeles, CA
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
3d
Utilization Review Nurse
Cobalt Benefits Group LLC —Dallas, TX
- $90,000 - $98,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- AD&D insurance
Quick Apply
9d
Utilization Review (UR) Coordinator - Per Diem
Meridell Achievement Center —Liberty Hill, TX
- Part-time
- Background check
- LMFT
- Nursing
- Health insurance
- Dental insurance
Quick Apply
2d
Utilization Review Nurse
HAMASPIK CHOICE INC —Spring Valley, NY
- $45 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Utilization Review RN
Memorial Health —Springfield, IL
- $32.95 - $52.73 an hour
- Full-time
- Acute care
- Nursing
- RN License
Clinical Operations and Workflow Project Manager (RN, LVN, LPN): Chicago, IL
Caregenix —Chicago, IL
- $60,000 - $90,000 a year
- Full-time
- Nursing
- Anatomy knowledge
- LVN
- Health insurance
- Dental insurance
Quick Apply
1d
Utilization Review Nurse (Medicare)
HAMASPIK CHOICE INC —Spring Valley, NY
- $41 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Director of Utilization Review/Management
River Oaks Hospital —New Orleans, LA
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN Case Manager - Surgery Services
UCLA Health —Los Angeles, CA
- $65.53 - $84.75 an hour
- Nursing
- Surgery
- RN License
Utilization Management Nurse
TEXAS INDEPENDENCE HEALTH PLAN INC —Austin, TX
- Weekends as needed
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Utilization Specialist
RiverWoods Behavioral Health —Riverdale, GA
- Part-time
- CPR Certification
- Nursing
- RN License
RN Admissions Part Time
Tufts Medicine Behavioral Health Hospital —Malden, MA
- $42.95 - $51.28 an hour
- Part-time
- CPR Certification
- Nursing
- RN License

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RN Director of Care Management - Sign-On Bonus Eligible

Merit Health River Region -
Vicksburg, MS

Quick Apply

Job Details

Full-time

Benefits

Relocation assistance
Health insurance
Dental insurance
Paid time off
Leadership training provided
Vision insurance
401(k) matching
Employee discount
Opportunities for advancement
Life insurance

Qualifications

RN License

Full Job Description

Why You’ll Love Working Here?

Sign-On Bonus and/or Relocation Reimbursement Offered
Competitive Compensation – Salary and benefits package designed to reward your expertise, leadership, and contributions.
Comprehensive Health Coverage – Medical, dental, vision, and life insurance options to support you and your family.
Future Security – 401(k) retirement plan with employer matching to help you build long-term financial stability.
Generous Paid Time Off – Paid Time Off (PTO) and Extended Illness Bank (EIB) to support work-life balance and personal well-being.
Career Growth Opportunities – Professional development, leadership training, and advancement opportunities across our organization.
Recognition & Reward Programs – We celebrate employee achievements and contributions to our success.
Exclusive Employee Discounts & Perks – Access to special savings and benefits designed for our team members.

Role: RN Director of Care Management
Location:Vicksburg, MS

Schedule: Day Shift Hours

Job Summary

The Director, Care Management is responsible for overseeing the implementation, development, and management of the Care Management and Resource Management programs. This position ensures compliance with all regulatory requirements, establishes efficient processes for patient care and discharge planning, and provides leadership to the Care Management team. The Director works collaboratively with staff, physicians, and community resources to deliver patient-centered care and achieve optimal outcomes.

Essential Functions

Oversees the implementation and maintenance of an effective and compliant Care Management program that meets all regulatory and accreditation standards.
Provides leadership and direction to staff, ensuring accountability for duties and adherence to roles within their scope of practice.
Conducts chart reviews to evaluate severity of illness (SI) and intensity of services (IS) for admissions, continued stays, and discharge planning.
Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up.
Identifies avoidable days and implements communication systems to address and resolve them effectively.
Coordinates discharge planning and social services functions to ensure compliance with federal and state laws and Joint Commission standards.
Acts as a liaison to community agencies, providing resources and services for post-hospital placement and support.
Ensures accurate and timely reporting of CPS (Child Protective Services) or APS (Adult Protective Services) cases as mandated, and educates staff on mandatory reporting requirements.
Participates actively in Patient Care Conferences and Length of Stay (LOS) meetings to support efficient care delivery and discharge planning.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.

Leadership Responsibilities

Supervision and Staff Management
- Provides leadership, mentorship and professional development opportunities for departmental staff.
- Schedules employees to ensure effective use of resources. Consults with leadership on any potential staffing issues.
- Conducts performance evaluations, sets goals and provides feedback to staff on their performance and development.
Strategic Planning and Financial Oversight
- Collaborates with hospital leadership to set the strategic direction for the department, including budgeting, resource allocation and long-term planning.
- Monitors expenditures, ensuring cost-effective delivery of services.
- Evaluates and implements new technologies to enhance operational efficiency.
- Develops and implements departmental policies and procedures and protocols to optimize quality and overall efficiencies.
Quality Assurance and Regulatory Compliance
- Ensures compliance with all relevant regulatory bodies. May oversee the accreditation process with relevant agencies ensuring that services meet or exceed industry standards.
- Participates in audits, inspections and accreditation processes as applicable.
- Follows established quality control practices to ensure accuracy, consistency and safety.
Collaboration and Communication
- Works closely with leadership teams to coordinate and improve service delivery.
- Stays up-to-date with industry advancements, new technologies, and regulatory changes.
Staff Responsibilities
- May work in a staff role, when required. Ensures that duties and responsibilities are fulfilled while meeting all competencies established for that job.

Qualifications

Bachelor's Degree in relevant field required or
Seven (7) plus years of direct experience in lieu of a Bachelor's degree required
Master's Degree preferred
3-5 years of experience in closely related field with Bachelor's degree required
3-5 years of previous leadership experience preferred

Knowledge, Skills and Abilities

Strong leadership, organizational, and communication skills.
Ability to collaborate with interdisciplinary teams and manage cross-functional relationships.
Foster a positive work environment that promotes teamwork, professionalism, and continuous improvement.
Communicate effectively with leadership, team members, and stakeholders.
Ability to work effectively with others, delegate responsibilities, and independently manage tasks while meeting established deadlines.
Problem-solving and critical thinking skills.
In depth knowledge of industry best practices and regulatory compliance (if applicable).
Strong organizational and time management skills.
Proficiency with Google and Microsoft platforms, healthcare software systems, and data analysis tools.

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure required
BCLS - Basic Life Support within seven (7) days of hire or transfer to position required

Why Work at Merit Health River Region?
At Merit Health River Region, we’re more than healthcare providers, we’re a team dedicated to compassionate care and community wellness. Join us for a supportive work environment, opportunities for professional growth, and the chance to make a real difference in the lives of our patients every day. Your skills, your passion, and your commitment matter here.

This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.

INDLEAD

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Rn Utilization Review jobs

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Pre-Authorization RN - $15,000 Sign-On Bonus or Student Loan Assistance!

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Utilization Review Nurse

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Utilization Review RN

Clinical Operations and Workflow Project Manager (RN, LVN, LPN): Chicago, IL

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Director of Utilization Review/Management

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