- State of Connecticut, Department of Administrative Services (Middletown, CT)
- …eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) ... Utilization Review Nurse (40 Hour) Office/On-site Recruitment...(https://www.elicense.ct.gov/) online (expand the 'Public Health Practitioners' grouping, select ' Registered Nurse ' and then 'Start'; + Request… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board… more
- LA Care Health Plan (Los Angeles, CA)
- Facility Site Review Nurse Specialist RN II Job Category: Clinical Department: Facility Site Review Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Facility Site Review (FSR) Nurse Specialist RN ...and time-management skills. Proficient in Microsoft Office. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as… more
- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Utilization Review Nurse - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of Case ... Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work experience. Preferred: + Associate… more
- InnovaCare (San Juan, PR)
- …to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization ... visits to Acute, SNF, and Rehabilitation Inpatient facilities to concurrently review admissions and continued stay to determine appropriate Utilization, Quality… more
- UCLA Health (Los Angeles, CA)
- Description As the Utilization Management & Quality Review Nurse , you will be responsible for: + Ensuring appropriate, cost-effective, and high-quality care for ... candidate with: * A BSN or MSN degree, required * Current valid California RN license, required * Two or more years of experience in utilization management,… more
- Pipeline Health System, LLC (Toast, NC)
- …Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse ( RN ) position supports the Mission of Pipeline Health ... care to our patients. This position is responsible for utilization review , assessment of discharge planning needs and coordination of effective discharge… more
- The Arora Group (Bethesda, MD)
- …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed...or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as… more
- State of Georgia (Thomas County, GA)
- Registered Nurse (Regional Quality Review (RQR)) - Region 4 Georgia - Thomas - Thomasville ... main office for DBHDD is located in downtown Atlanta. Job Description Job Title: Registered Nurse ( Regional Quality Review (RQR) ) - Region 4 (Thomasville,… more
- Travelers Insurance Company (Buffalo, NY)
- …parameters within their assigned state preferred. **What is a Must Have?** + Registered Nurse ; Licensed Practical Nurse or Licensed Vocational ... Imagine loving what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range provided… more
- Virtua Health (Marlton, NJ)
- …skilled services in Burlington, Camden and Gloucester counties. We are seeking a Registered Nurse with prior home health experience, OASIS certification and ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- US Tech Solutions (Chicago, IL)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... months of Prior Authorization. **Education:** + Active and unrestricted RN licensure in state of residence **Questionnaire:** + Do... Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure required Pay Range: ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- US Tech Solutions (May, OK)
- …experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... clinical policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. . Reviews… more
- Actalent (Omaha, NE)
- …NurseJob Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will be responsible for ... and preauthorization processing. This role involves accurate and timely medical review of claims, preauthorizations, and customer service inquiries. You will also… more
- HCA Healthcare (Corpus Christi, TX)
- …in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates will ... **Description** **Introduction** **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN you want in your current role? We invest… more
- US Tech Solutions (Columbia, SC)
- …the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- HCA Healthcare (Mcallen, TX)
- …efficiently. Are you passionate about delivering patient-centered care? Submit your application for Registered Nurse Quality position and spend more time at the ... may vary by location._ **Job Summary and Qualifications** The Review Nurse Clinical Reviewer position encompasses multiple...in your career! We are interviewing candidates for our Registered Nurse Infection Prevention opening. Apply today… more
- Centene Corporation (Sacramento, CA)
- …on workplace flexibility. **Fully Remote position that requires a CA RN Licensure.** **Position Purpose** : Performs concurrent reviews, including determining ... utilization management processes preferred. **License/Certification:** **For Health Net of California: RN license required** Pay Range: $25.97 - $46.68 per hour… more