- 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
- 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
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Quality Review Nurse ( RN ) is to evaluate clinical quality and procedures within the Clinical Appeals & ... is required in addition to the required work experience. **Licenses/Certifications:** + Health Services\ RN - Registered Nurse - State Licensure and/or… 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
- 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
- Premier Health (Troy, OH)
- Position: ASSOCIATE NURSE MGR/ UTILIZATION REVIEW RN Dept: Inpatient Behavioral Health Shift: Full time 72 hours/pp: 7am-7:30pm Facility: Upper Valley ... POSITION: 24 HOURS/PP ASSOCIATE NURSE MANAGER AND 48 HOURS/PP UTILIZATION REVIEW RN ._** The **Associate Nurse Manager (ANM)-Inpatient Unit** serves as an… 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
- Hackensack Meridian Health (Little Falls, NJ)
- …+ Home Care Experience Licenses and Certifications Required: + NJ State Professional Registered Nurse License. + Certificate for Oasis Specialist (COS-C, COQS, ... coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine that the coding… more
- Hackensack Meridian Health (Brick, NJ)
- …+ Home Care Experience Licenses and Certifications Required: + NJ State Professional Registered Nurse License. + Certificate for Oasis Specialist (COS-C, COQS, ... coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine that the coding… more
- Travelers Insurance Company (Albany, 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
- 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
- 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
- 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
- Centene Corporation (Sacramento, CA)
- …flexibility. **Location: Position is 100% remote. Candidate must have CA RN Licensure.** **Position Purpose:** Analyzes all prior authorization requests to determine ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… 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
- Centene Corporation (Reno, NV)
- …reside in the state of Nevada with experience (2) with an active compact LPN or RN licensure and willingness to obtain other licensure as needed (3) as well as some ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and leadership programs + And more **Description** We're seeking a ** Registered Nurse , Clinical Utilization Preceptor** responsible for training, mentoring, ... and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at… more
- Sodus Rehab & Nursing Center (Medford, MA)
- …of Science in Nursing (preferred) . Current registration and license to practice as a Registered Nurse in the state employed in . Peripheral IV certification . ... daily to observe and evaluate each resident's physical and emotional status . Review the nurse 's notes to ensure that they are informative and descriptive of the… more
- Sodus Rehab & Nursing Center (Medina, NY)
- …of Science in Nursing (preferred) . Current registration and license to practice as a Registered Nurse in the state employed in . Peripheral IV certification . ... daily to observe and evaluate each resident's physical and emotional status . Review the nurse 's notes to ensure that they are informative and descriptive of the… more