- Novo Nordisk Inc. (Houston, TX)
- …Externally, the DCS I maintains relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and other ... Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify… more
- Merck & Co. (TX)
- …may include :- Health care providers such as physicians, physician assistants, nurse practitioners, nurses, pharmacists as well as quality directors and office ... at product workshops and conferences, as well as consistent and ongoing review of Company promotional materials.Providing Company management with updates on customer… more
- Merck & Co. (MA)
- …channels of drug distribution, Oncology GPO's, wholesalers and specialty pharmacies. Review and evaluate patterns for products purchased and prescribed, outpatient ... and functional areas; ensure integration with the Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and other key… more
- Merck & Co. (Memphis, TN)
- …channels of drug distribution, Oncology GPO's, wholesalers and specialty pharmacies. Review and evaluate patterns for products purchased and prescribed, outpatient ... divisions and functional areas; ensureintegration with the Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and other… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider ... appeals that require medical review to determine if the claim...clinical experience, previous case management, discharge planning or utilization review experience. **Licenses/Certifications** RN - Registered Nurse … more
- Molina Healthcare (Columbus, OH)
- …DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate ... + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in… more
- HCA Healthcare (Austin, TX)
- …path, we encourage you to apply for our Medical Surgical Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Description** **Introduction** Do you have the career opportunities as a(an) Medical Surgical Registered Nurse you want in your current role? We invest in what… more
- HCA Healthcare (Austin, TX)
- …we encourage you to apply for our Seasonal Medical Surgical Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Introduction** Do you have the career opportunities as a(an) Seasonal Medical Surgical Registered Nurse you want in your current role? We invest in what… more
- HCA Healthcare (Plano, TX)
- …path, we encourage you to apply for our Medical Oncology Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Description** **Registered Nurse / RN - Medical Oncology** **Shift: Full time - Nights** **Location: Medical City Plano Hospital** **Introduction** **Do… more
- HCA Healthcare (Dallas, TX)
- …career path, we encourage you to apply for our Medical ICU Registered Nurse opening. We review all applications. Qualified candidates will be contacted by a ... **Description** **Introduction** Do you have the career opportunities as a Medical ICU Registered Nurse you want in your current role? We invest in what matters… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate,...clinical information and may also provide education on the medical review process. + The Contractor performing… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 250102-5612FP-001 Location Hartford, CT Date Opened 1/6/2025 12:00:00 AM Salary $78,480 - ... Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) ! Bring your skills… 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 ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… 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
- Molina Healthcare (Manhattan, NY)
- …who are eligible for Medicaid and Medicare. We are looking for Registered Nurse Care Review Clinicians with Prior Authorization experience. Experience with ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- HCA Healthcare (Webster, TX)
- …your knowledge and expertise! **Job Summary and Qualifications** We are seeking a Registered Nurse (RN) Quality - Peer Review Coordinator for our facility to ... In Your Role:** + You will support the peer review processes of the Medical Staff +...Trustees **What qualifications you will need:** + Current Registered Nurse License in the State of Texas or Multi-State… more
- FlexStaff (Uniondale, NY)
- **Req Number** 147980 JOB PURPOSE: Under the direction of the Senior Director of Clinical Review , the Clinical Review Nurse is responsible for complying with ... of Clinical Review will monitor the Clinical Review Nurse 's activities and outcomes, ensuring compliance...Physician and/or Medical Director to ensure that medical review of specific cases occurs timely… more
- Centene Corporation (New York, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance… more
- Centene Corporation (New York, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies… more
- University of Washington (Seattle, WA)
- …) **UW Medical Center** has an outstanding opportunity for an **experienced Utilization Review Nurse (UM RN)** to join our team. **WORK SCHEDULE** + Fully ... Req #: 236354 Department: UW MEDICAL CENTER - UTILIZATION MANAGEMENT Job Location Detail:...training + Active licensure to practice as a Registered Nurse in Washington State required by start date +… more
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