- CHRISTUS Health (Wake Village, TX)
- Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for evaluating, coordinating, processing, screening, and documentation of patient ... entry into the CHRISTUS Health System. The Registered Nurse Clinical Care Coordinator will collaborate with relevant providers and partners to determine the… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in ... will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties… 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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001 Location East Hartford, CT Date Opened 11/7/2024 12:00:00 AM ... (https://portal.ct.gov/dds/searchable-archive/northregion/north-region/welcome-to-the-north-region?language=en\_US) - is accepting applications for a full-time Utilization Review Nurse Coordinator… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 241023-5612FP-001 Location Middletown, CT Date Opened 11/5/2024 12:00:00 AM Salary $78,480 - ... Families (DCF (https://portal.ct.gov/dcf) ), seeks qualified individuals for a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) position.… more
- Martin's Point Health Care (Portland, ME)
- …Point 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 ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
- US Tech Solutions (Chicago, IL)
- …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Ascension Health (Tulsa, OK)
- …planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance ... **Additional Preferences** + 2+ years of bedside nursing experience + 2+ years of Utilization Review experience **Why Join Our Team** Ascension St. John has been… more
- BayCare Health System (Clearwater, FL)
- …team member be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Nurse - Health Plan **Location** ... **Experience:** + 2 years - Case Management + 2 years - Utilization Review + Directly working for Medicare Advantage Plan - preferred **Facility:** BayCare… more
- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… 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 New Century Health Plan members + Conducting utilization management (UM) activities in accordance with health plan...required * Two or more years of experience in utilization management, preferably in Medicare Advantage or managed care… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse (RN) ... compassionate care to our patients. This position is responsible for utilization review , assessment of discharge planning needs and coordination of effective… more
- Travelers Insurance Company (Buffalo, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ..... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
- UPMC (Hanover, PA)
- **UPMC is hiring a Professional Care Manager to support the Utilization Review process! This is a full time, day shift position with a rotating weekend and ... holiday schedule.** This is a nonpatient-facing position. This Registered Nurse is responsible for completing medical necessity reviews utilizing Indicia and… 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 ... compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work experience.… more
- CVS Health (Columbus, OH)
- …on Fridays until 5pm Arizona Time. **Preferred Qualifications** -1+ years' experience Utilization Review experience -1+ years' experience Managed Care - Strong ... to make health care more personal, convenient and affordable. **Position Summary** **This Utilization Management (UM) Nurse Consultant role is 100% remote and… more
- CVS Health (Olympia, WA)
- …Long term care, cardiology -1+ years' experience in either Precertification or Utilization Review **Preferred Qualifications** -1+ years' experience Managed Care ... to make health care more personal, convenient and affordable. **Position Summary** This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more
- Crouse Hospital (Syracuse, NY)
- …Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization Management RN is an ... on their appropriate admission status. This individual will support the Utilization Management process by maintaining effective and efficient processes for… more
