- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... utilization reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance with industry… more
- Lourdes Health (Pasco, WA)
- …fosters an environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning and swing ... Registered Nurse (RN), House Supervisor Job Type: Full-time Varied...assists in patient care and is responsible for overall quality of patient care in the facility. Supervises and… more
- Lourdes Health (Pasco, WA)
- …fosters an environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning and swing ... Registered Nurse (RN), House Supervisor Job Type: Full Time...assists in patient care and is responsible for overall quality of patient care in the facility. Supervises and… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management/appropriateness: Assess assigned patient population for medical ... Proactively refers cases to physician adviser for P2P, medical necessity review , and denail avoidance. Demonstrates and maintains current knowledge of regulatory… more
- Fresenius Medical Care (Fayetteville, NC)
- …following all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance ... larger range within the department. Responsible for supporting and driving FMS quality standards through meeting all ESRD regulatory requirements and the practice of… more
- Fresenius Medical Care (Ponca City, OK)
- …As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility ... the operations of the clinic, including costs, processes, staffing, and quality standards. Provides leadership, coaching, and development plans for all direct… more
- CenterWell Home Health (Pittsfield, MA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- University Health (San Antonio, TX)
- …years recent, full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is ... department and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF… more
- Interim HealthCare (Greenwood, IN)
- …Nurse (RN) in home health or similar setting; previous case management/ utilization review experience preferred. OASIS experience preferred. Practical trach ... Description Our Registered Nurse Case Managers (RNCM) have been called to...our unmatched referral response times to our focus on quality improvement, the most beautifully complicated time of your… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …evolve, so does our challenge to find better and more innovative ways to improve their quality of life. We're changing lives for a living. Are you ready to make a ... relationships include key opinion leaders (KOL's), academic institutions, physicians, nurse practitioners, diabetes educators, pharmacists, blood bank staff, organized… more
- University Health (Seguin, TX)
- …years recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice...the State of Texas to practice as a registered nurse is required. National certification in related field is… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality / Utilization Review Nurse Position Summary: The Quality / Utilization Review Nurse is responsible for evaluating the medical ... years of clinical nursing experience (acute care preferred). o Prior experience in utilization review , case management, quality improvement, and infection… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251119-5613FP-001 Location Middletown, CT Date Opened 12/11/2025 12:00:00 AM ... Campus Hospital (https://portal.ct.gov/dcf/solnit-center/south) - is accepting applications for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... evidence-based practice * Quality of Practice*: * Promotes quality through evidence-based utilization review ... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry,...the plan of care and services provided are patient-focused, high- quality , efficient, and cost-effective. Serves as a preceptor and… 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...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40...medical care delivery and reimbursement systems; + Participates in utilization review and/or quality assurance ... and Addiction Services ( DMHAS (http://portal.ct.gov/DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) !… more
- Emory Healthcare/Emory University (Decatur, GA)
- …development _,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor (Registered Nurse / ... be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an...timely in order to ensure consistent expectations and maintain quality throughout the department. + Is required to ensure… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
