- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York State Psychiatric Institute, P25409 Occupational Category ... Minimum Qualifications New York State Psychiatric Institue is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and… more
- The Arora Group (Bethesda, MD)
- …+ The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. + The ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently...or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as… more
- Billings Clinic (Billings, MT)
- …to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN Billings ... - 44.18 Under the direction of department leadership, the Utilization Review / Management RN . This...and Certification Healthcare Provider and ACLS CPR certifications Current Registered Nurse license in the state of… more
- UTMB Health (Galveston, TX)
- Utilization Review Case Mgr. - Galv....nursing and current Texas Nursing licensure as a professional registered nurse . Minimum of three years of ... full time wage earning experience as a professional nurse in a health care setting. **JOB DESCRIPTION :**...criteria guidelines. **MAJOR DUTIES / CRITICAL TASKS:** + Implements Utilization review procedures by prospectively, concurrently, and… more
- HCA Healthcare (Nashville, TN)
- …want your knowledge and expertise! **Job Summary and Qualifications** **As a Utilization Review Services Registered Nurse , you will focus on initial and ... **Introduction** Do you have the career opportunities as a(an) Utilization Review Nurse BH WFH...RN include the following:** + **Conduct medical record review , validate admission status order, conduct a medical necessity… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of care and promoting ... planners regarding transition to alternative levels of care. + Perform concurrent utilization review applying identified criteria at prescribed review … more
- BayCare Health System (Cotton Plant, AR)
- …Critical Care or Emergency Nursing RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... clinical excellence. **BayCare Health System** is currently seeking a ** Utilization Review Specialist Senior** to join our...2 years in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency… more
- Elevance Health (Tampa, FL)
- **Licensed Utilization Review II** **Location** : KS, FL. and VA. This is a remote position The ideal candidate will live within 50 miles Elevance Health ... Monday through Friday,10:30 - 7:00 Eastern time** The **Licensed Utilization Review II** responsible for working primarily...unrestricted license or certification as a LPN, LVN, or RN to practice as a health professional within the… more
- Centene Corporation (Jefferson City, MO)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Trinity Health (Silver Spring, MD)
- …activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... will need:** + State of Maryland license as a Registered Nurse + BSN required; MSN Degree...in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …programs + And more **Description** We're seeking an **Assistant Manager, Utilization Review ** , responsible for supervising and coordinating activities ... of personnel in the Utilization Review Department, including: + Staff schedules...Minimum Qualifications: + Must have a valid, active unencumbered Registered Nurse license or temporary permit approved… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. **Title: Utilization Review Nurse ** **Location: Hospital Client ... vary and some flexibility may be offered** As our ** Utilization Review Nurse ** , you...other opportunities that promote growth. **Required Skills:** + Active Registered Nurse license For this US-based 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 ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...and offerings. Education/Experience: + Unrestricted state license as a Registered Nurse required; BSN preferred. + 3+… more
- UCLA Health (Los Angeles, CA)
- …You can do all this and more at UCLA Health. In this role as a Utilization Review Supervisor within our utilization department you would be responsible for ... within NPH. This role entails overseeing a team of utilization review nurses, ensuring compliance with clinical...+ BSN or MSN, Required + Current valid CA RN License, required + BLS from the ARC or… more
- Independent Health (Buffalo, NY)
- …first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Utilization Review Nurse performs clinical reviews to determine ... criteria or IHA policy. **Qualifications** + Active, current, unrestricted, and licensed registered nurse required. Associates degree in health related field;… 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
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
- UNC Health Care (Rocky Mount, NC)
- …Carolina license without sanctions)** Preferred Certifications & Licensures + Utilization Review or other applicable certification **Professional Experience ... - acute care (acute hospital setting) + 0-2 healthcare/medical - - utilization review (or other healthcare-related experience) Preferred Experience: +… more
- Baptist Memorial (Memphis, TN)
- Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as ... prescribed by utilization review standards. The UR ...+ Employee referral program Job Summary: Position: 19737 - RN - Utilization Review Facility: BMHCC Corporate… more
- McLaren Health Care (Bay City, MI)
- …+ Nursing degree from an accredited educational institution + State of Michigan licensure as a Registered Nurse ( RN ) + Two years of recent clinical or ... management to expedite patient discharge. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of… more