17 utilization review case manager jobs at 16 companies in Middletown, DE
2w
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Utilization Review Nurse
West Chester, Pennsylvania, United States
OnsiteFull Time
3+ YOERequired PA RN license, associate or bachelor's degree in nursing, 3+ years nursing experience, and 1+ year utilization review experience; certified case manager credential required.
InterQual, electronic health record
2mo
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Utilization Review Specialist
Chadds Ford, Pennsylvania, United States
HybridFull Time
1+ YOEBachelor's degree in a related field, 1+ years utilization review/case management or behavioral health revenue cycle experience, strong understanding of medical necessity and authorization processes, attention to detail, and strong communication skills.
EHR
1w
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Utilization Review Nurse (Full-Time)
Towson, Maryland, United States
$68k-$110k/yr OnsiteFull Time
5+ YOEMaryland RN license and BSN, or ASN with enrollment in a BSN program. Requires 5 years acute-care experience, including 2 years utilization review and case management experience.
InterQual, MCG, Electronic Medical Records (EMR)
3w
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RN Case Manager - Utilization Review (Temple Hospital Jeanes Campus)
Philadelphia, Pennsylvania, United States
HybridFull Time
2+ YOEActive PA or multi-state RN license, BSN required, minimum 2 years clinical nursing experience preferred; experience with utilization review/InterQual/MCG and Medicare/Medicaid guidelines; strong clinical judgment and communication.
InterQual, MCG
3w
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Case Manager
Baltimore, Maryland, United States
$37-$66/hr OnsiteFull Time
3+ YOEDegree in nursing and valid RN license required; 3 years clinical experience; medical/surgical, managed care, case management, and utilization review (MCG) experience preferred.
MCG
3w
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LPN Case Manager
Delaware County, Pennsylvania, United States
$75k/yr RemoteFull Time
Licensed LPN in Pennsylvania with case management or admissions experience in long-term care; ability to coordinate with payers, manage utilization review, and document in EHR.
EHR
5d
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PRN Case Manager II
Philadelphia or Havertown
OnsitePart Time
2+ YOERequires nursing or social work postsecondary education, RN or LCSW/LSW licensure, and 2+ years in healthcare. Case management, utilization review, or discharge planning experience preferred.
Microsoft Office
1mo
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Registered Nurse Utilization Review
Baltimore, Maryland, United States
$81k-$116k/yr HybridFull Time
Maryland RN credential required; diploma from accredited nursing school or equivalent licensure; experience in utilization/case management preferred; knowledge of clinical documentation and payer regulations.
3w
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Nurse Case Manager
Towson, Maryland, United States
$81k-$122k/yr HybridFull Time
3+ YOEMaryland RN license required, 3-5 years nursing experience, case management/utilization review preferred, BSN preferred, CCM/WCCM/MCRSP certifications preferred, familiarity with Windows, Microsoft Word and Microsoft Excel.
Windows, Microsoft Word, Microsoft Excel
4d
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Case Manager-RN-Per Diem Days
Wildomar or Murrieta or Riverside County or King of Prussia or United States or Puerto Rico or United Kingdom
$56-$82/hr OnsitePart Time
3+ YOERequires 3+ years of acute care clinical experience, completion of an accredited RN program, and a current California RN license. Case management or utilization review experience is preferred.
1w
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RN Medical Review Nurse (Hybrid)
Woodbury, New Jersey, United States
$77k-$94k/yr HybridFull Time
3+ YOERegistered Nurse with 3+ years of clinical experience and 2+ years in health insurance, including utilization review or case management; strong analytical, organizational, decision-making, digital, and communication skills.
1w
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RN Medical Review Nurse (Hybrid)
Woodbury, New Jersey, United States
$77k-$94k/yr OnsiteFull Time
3+ YOERegistered Nurse with 3+ years clinical experience and 2+ years health insurance experience, including utilization review or case management. Requires strong analysis, organization, decision-making, digital literacy, and communication.
6d
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Clinical Medical Review Nurse (Remote)
Baltimore, Maryland, United States
$67k-$134k/yr RemoteFull Time
3+ YOERequires an RN license in VA, DC, or MD, high school diploma/GED, and 3 years of acute clinical experience plus case management, discharge planning, or utilization review experience.
Microsoft Office, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, web-based technology, CPT, HCPCS
2w
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Director of Case Management
Baltimore, Maryland, United States
$58-$104/hr OnsiteFull Time
3+ YOE4+ MgmtMaster's degree required; 3-4 years of experience and progressive leadership preferred, with case management, social work, or utilization review experience required. Maryland or DC RN licensure required.
computer software applications
2w
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Director of Case Management
Baltimore, Maryland, United States
$58-$104/hr OnsiteFull Time
3+ YOE4+ MgmtMaster's degree in nursing, healthcare administration, business administration, or related field; RN licensure in Maryland or DC; 3–4 years of experience in case management, social work, or utilization review; progressive leadership preferred.
computer software applications
2mo
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Clinical Review RN PRN
Camden, New Jersey, United States
$37-$61/hr OnsitePart Time
3+ YOEActive New Jersey RN license, 3+ years recent clinical experience (utilization management preferred), familiarity with Interqual/Milliman, EPIC Case Management, payer screening tools, strong communication and critical thinking; Monday availability required.
EPIC Case Management Module, Interqual, Milliman
1mo
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Clinical Appeals Nurse - Full Time Remote - Jefferson Health
Philadelphia, Pennsylvania, United States
RemoteFull Time
10+ YOEActive PA RN license, bachelor’s in nursing or specialized diploma, 10 years clinical or case management/utilization review, knowledge of Interqual/medical policy, coding, and payor rules, Epic and Excel experience, RCE training.
Epic, Microsoft Excel, Microsoft Word