Top 6660 Utilization management rn Jobs

Nurse Manager Case Management and Utilization Review
Clinical Management Consultants —Tucson, AZ
- $128,660 - $154,700 a year
- Full-time
- Acute care
- Nursing
- Acute care experience
- Tuition reimbursement
- Paid time off
RN Team Lead Utilization Review
MedStar Health —Clinton, MD
- $89,065 - $162,801 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Hospital
Quick Apply
Utilization Review RN - Urgent Hiring
InfiCare —Syracuse, NY
- $65 an hour
- Contract
- CPR Certification
- Microsoft Excel
- Microsoft Outlook
Quick Apply
3h
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Utilization Management Clinical Reviewer
CuraFi —Remote
- $140,000 - $160,000 a year
- Full-time
- RN License
- Senior level
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
14d
Medical Management - Utilization Management RN 145-2011
CommunityCare —Remote
- Full-time
- Remote
- Background check
- Nursing
- RN License
Quick Apply
11d
Medical Management - Utilization Management RN 145-2026
CommunityCare —Remote
- Full-time
- Remote
- Background check
- Nursing
- RN License
Quick Apply
11d
Utilization Management Registered Nurse (RN) - Remote
Guidehealth —Chicago, IL
- $70,000 - $75,000 a year
- Full-time
- Remote
- Microsoft Word
- Nursing
- Microsoft Excel
- Paid parental leave
- Disability insurance
Utilization Review RN, Case Management/UR, Full Time, Day Shift, Job ID # 1815702
Palmetto General Hospital —Hialeah, FL
- Full-time
- Microsoft Outlook
- RN License
- Computer literacy
14d
RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)
Molina Healthcare —California
- $30.37 - $59.21 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Discharge planning
- Health insurance
RN - Case Manager - AS Utilization Management - Part Time - 8 Hour - Days
John Muir Health —Walnut Creek, CA
- $89.23 - $121.58 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
RN - Case Manager - AS Utilization Management - Full Time - 8 Hour - Days
John Muir Health —Walnut Creek, CA
- $89.23 - $121.58 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
Utilization Management Nurse RN
Signature Consulting Services LLC —Louisville, KY
- $75,000 - $82,000 a year
- 8 hour shift
- Remote
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
Utilization Management RN
WelbeHealth —Los Angeles, CA
- $99,309.58 - $131,088.64 a year
- Remote
- Mid-level
- 3 years
- Supervising experience
- Health insurance
- Dental insurance
Quick Apply
1d
ISNP Utilization Management Nurse
Longevity Health —Remote
- $81,000 - $99,000 a year
- Full-time
- Nursing
- Clean driving record
- RN License
Quick Apply
12d
Denials & Appeals Administrator (RN)
Boston Medical Center —Remote
- $43.03 - $62.50 an hour
- Full-time
- Remote
- Nursing
- RN License
- 5 years
- Health insurance
- Dental insurance
RN - Case Manager - AS Utilization Management - Walnut Creek - Full Time - 8 Hour - Days
John Muir Health —Walnut Creek, CA
- $87.06 - $118.62 an hour
- 8 hour shift
- Nursing
- Microsoft Outlook
- RN License
Utilization Management Nurse
Blue Eagle Consulting —Remote
- RN License
- Mid-level
- Nursing
Quick Apply
Health Nurse - Utilization Management
Alterwood Health —Remote
- $75,000 - $95,000 a year
- Full-time
- Microsoft Word
- Background check
- Nursing
- Health savings account
- Disability insurance
Quick Apply
14d

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Nurse Manager Case Management and Utilization Review

Clinical Management Consultants -
Tucson, AZ

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Job Details

Full-time
$128,660 - $154,700 a year

Benefits

Tuition reimbursement
Paid time off
Retirement plan

Qualifications

Managed Registered Nurses (RNs)
Nursing department supervision
Hospital rounding experience
Nursing
Utilization review
Overseeing healthcare denial management
CMS
Nursing team management
Operations coordination planning
Quality improvement leadership
Leadership development
Managing patients as a nurse case manager
Team development
Transitional care planning in clinical case management
CMS regulatory compliance
Professional development support
Evidence-based practice
InterQual
Utilization management
Resource utilization in healthcare
Multidisciplinary team collaboration for treatment planning
Concurrent review in utilization management
Insurance provider collaboration
Milliman Care Guidelines (MCG Health)
Acute care experience
Senior level
Care coordination
Hospital regulatory compliance
Medical claim denial management
Hospital patient care services

Full Job Description

Nurse Manager Case Management and Utilization Review opportunity at an award winning hospital in Southern Arizona, lead bold improvements in access, outcomes, and experience while having fun doing it!

The Nurse Manager Case Management and Utilization Review will join a mission-driven, patient-first culture known for clinical excellence, strong safety performance, and consistent quality outcomes supported by real-time analytics, modern EHR optimizations, and AI-informed decision support for throughput and utilization review; this healthcare organization celebrates recent PR momentum, high brand trust in the community, Magnet-inspired professional practice, robust shared governance, and leadership that listens through inclusive town halls and frontline-driven improvement, an environment where the Nurse Manager Case Management and Utilization Review can rapidly elevate care coordination, reduce avoidable days, and drive measurable value across acute and ambulatory settings.

The Nursing Manager Case Management will guide a highly collaborative Case Management service that thrives on care coordination, utilization management, discharge planning, and transitions-of-care excellence, partnering closely with social work, pharmacy, and physician advisors to streamline denials prevention, optimize length of stay, and enhance patient flow; in this award-winning hospital environment, the Nursing Manager Case Management will leverage evidence-based criteria (InterQual/MCG), payer collaboration strategies, and data transparency to ensure the right care, at the right time, in the right setting for every patient.

Reporting to a seasoned Director of Care Management with dotted-line collaboration to Quality, Revenue Cycle, and Population Health, the Nurse Manager Case Management and Utilization Review will lead a friendly, diverse, and high-performing team of RN Case Managers, UM Reviewers, and Social Work professionals; responsibilities include daily operations and staffing, concurrent review, escalation pathways with physician advisors, readmission reduction, observation management, avoidance of condition code 44 pitfalls, regulatory and CMS compliance, denial mitigation, and interdisciplinary rounding, with strong educator support, onboarding resources, and leadership development to help the Nurse Manager Case Management and Utilization Review grow a resilient, engaged team.

Set in Southern Arizona’s sun-drenched desert and mountain landscapes, the Nursing Manager Case Management role offers an enviable lifestyle with year-round outdoor recreation in saguaro-studded parks, stellar cycling routes, trail running, and golf; the region features vibrant arts and culture, music and food festivals, acclaimed Sonoran cuisine, a lively university influence, and a growing tech and healthcare job market; families appreciate diverse schools, parks, community programs, and plentiful youth sports, while professionals enjoy a lower cost of living than many Western metros, varied housing from historic bungalows to modern new builds, easy access to regional airports and highways, strong healthcare access, and a welcoming community vibe, making Southern Arizona a compelling home base for the Nursing Manager Case Management career path.

The Nurse Manager Case Management and Utilization Review will be offered competitive compensation aligned to experience and scope, plus a comprehensive benefits package that may include sign-on and relocation incentives, premium differentials, robust PTO, tuition assistance and paid CEUs, certification bonuses, mental health and wellness resources, and retirement plans with employer contributions; to explore this high-impact leadership role, connect today with a Clinical Management Consultants recruiter for a confidential conversation and take the next step toward advancing your Nursing Manager Case Management career in Southern Arizona.

Apply Now

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