• Utilization Review Nurse Supervisor…

    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
    The County of Los Angeles (09/30/24)
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  • Registered Nurse - Utilization…

    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
    Mohawk Valley Health System (10/28/24)
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  • Quality Review Nurse (Remote)

    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
    CareFirst (11/15/24)
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  • Concurrent Review Nurse -( Auditor)-…

    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
    InnovaCare (10/16/24)
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  • Utilization Review Registered

    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
    Pipeline Health System, LLC (10/26/24)
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  • Licensed Practical Nurse (LPN)…

    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
    The Arora Group (11/22/24)
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  • Associate Nurse Mgr / UR Review

    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
    Premier Health (11/07/24)
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  • Registered Nurse (Regional Quality…

    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
    State of Georgia (09/25/24)
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  • Clinical Review Nurse VHS- Woodland…

    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 (11/14/24)
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  • Clinical Review Nurse -FT (Ocean…

    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
    Hackensack Meridian Health (11/07/24)
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  • Utilization Review Nurse - Workers'…

    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
    Travelers Insurance Company (11/21/24)
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  • Utilization Review Nurse

    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 (10/18/24)
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  • Utilization Review Nurse

    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 (10/18/24)
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  • Utilization Review Nurse

    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
    US Tech Solutions (10/31/24)
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  • Clinical Review Nurse - Prior…

    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
    Centene Corporation (11/26/24)
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  • Registered Nurse Clinical Reviewer…

    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
    HCA Healthcare (11/01/24)
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  • Clinical Review Nurse - Concurrent…

    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
    Centene Corporation (11/24/24)
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  • Utilization Review Preceptor…

    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
    Emory Healthcare/Emory University (11/28/24)
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  • Registered Nurse ( RN )

    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 (11/01/24)
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  • Registered Nurse ( RN )

    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
    Sodus Rehab & Nursing Center (10/16/24)
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