- HumanEdge Travel Nursing and Allied Health (Hartford, CT)
- HumanEdge Travel Nursing and Allied Health is seeking a travel nurse RN Utilization Review for a travel nursing job in Hartford, Connecticut.Job Description & ... hours per weekShift: 8 hoursEmployment Type: TravelImmediate need for Utilization Review RNs for a Connecticut Healthcare...Connecticut Healthcare Network. After orientation, this will be a remote role. Must be close enough to the facility… more
- Merck & Co. (Los Angeles, CA)
- …care (transition of care) using approved messages and resources-Conducts appropriate business review of account performance to optimize net sales for our Company ... to the Customer including promotional positioning (support of appropriate utilization ) and/or provider quality and outcomes-based activities.Provides feedback to and… more
- Merck & Co. (Durham, NC)
- …culture by reducing waste and constantly driving continuous improvement-- Review and approve compliance documents, as per procedures or need.Supply/Support ... Management - Creating and sustaining a highly engaged workforce through the utilization of Company Leadership Behaviors and Inclusion - Provide coaching on… more
- Merck & Co. (Durham, NC)
- …culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply - ... - Responsible for creating and sustaining a highly engaged workforce through utilization of our Company Leadership Behaviors and Inclusion.- Provide coaching on… more
- Aequor (New York, NY)
- …York State Prefer minimum of 1-3 years relevant experience in case management, utilization review and/or quality assurance Experience in acute episodic care, ... Contractor Position (First 6 months- 5 days onsite, then 4 days/week onsite and 1 day remote ) 8:30 AM to 4:30 PM (Monday - Friday) New York Headquarters - 66 Hudson… more
- Saint Francis Health System (Tulsa, OK)
- …Time7p - 7aVirtual Nurse works from an on-site office location (not a remote position)Will perform admit, discharge chart review and other patient care ... toward goals. Facilitates patient discharge through timely, appropriate referrals and utilization of patient education resources, suitable to patient age and… more
- Actalent (Kansas City, KS)
- Job Title: Utilization Review - Post Acute Care Job Description Our PAC Nurse is a telephonic role responsible for recommending discharge plans, assisting with ... care management + Length of stay management + Concurrent Review Job Type This is a Contract-to-Hire position with...of 12 Month(s). Work Site This is a fully remote position. Work Environment Post Training, the schedules are… more
- CVS Health (Raleigh, NC)
- …training, position is remote with occasional in office requirement. Utilization Review - Precertification Nurse is responsible for telephonically assessing, ... care innovators. Fundamentals:Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit plan eligibility… more
- Henry Ford Health System (Detroit, MI)
- …+ Innovative Team Structure:Benefit from our new dyad Social Work/RN Case Manager model and remote utilization review setup, allowing you to excel in your ... transition to the next level of care seamlessly. Perks of the Role: + Remote Flexibility:After 6 months, enjoy the option to work weekends and holidays remotely with… more
- Pipeline Health System, LLC (Gardena, CA)
- …transfer processes and escalations. The Patient Hub Transfer Coordinator works closely with the remote Utilization Review (UR) Nurses to assure the patient ... meets inpatient status prior to accepting the transfer. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET… more
- McLaren Health Care (Indianapolis, IN)
- …for utilization management functions. This includes but is not limited to review and authorization of services, utilization of medical policy, utilization ... We are looking for a Utilization Management, RN - IN to join us...complex cases and special projects. **This is a fully remote position.** **Equal Opportunity Employer of Minorities/Females/Disabled/Veterans** **\#LI-AK1** **Qualifications:**… more
- Kepro (Indianapolis, IN)
- …Acentra seeks a Utilization Management (UM) Nurse Clinical Reviewer - LPN/RN ( Remote US) to join our growing team. Job Summary: The purpose of this position ... is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with...or Bachelor's Degree Nursing Program. + 2+ years of Utilization Management (UM) experience from the State, Hospital, or… more
- Kepro (Los Angeles, CA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Utilization Clinical Reviewer to join our growing team. Job Summary As a Utilization ... for ensuring the accuracy and consistency of the Psychiatric Inpatient Concurrent Review process in alignment with the esteemed California Mental Health Services… more
- Insight Global (Philadelphia, PA)
- …to Case Management when indicated. Efficiently collaborates with the hospital utilization review department, attending physicians and members/families as ... insurance company local to the Philadelphia area is looking for to hire a fully remote Case Management RN to join their Care management team. Under the direction of… more
- Centene Corporation (Austin, TX)
- …insight and guidance on the review of member medical records to the utilization review BH team + Provides guidance and expert knowledge as appropriate to ... the behavioral health utilization review team members to ensure the...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Kepro (Los Angeles, CA)
- …for health solutions in the public sector. Position Overview: As a Utilization Reviewer, you involves reviewing medical records against appropriate criteria and ... ensures the accuracy and consistency of the Psychiatric Inpatient Concurrent Review process with the California Mental Health Services Authority (CalMHSA).… more
- Insight Global (New York, NY)
- …here https://www.nursys.com/LQC/LQCTerms.aspx and send to me with QB - 4-5 years of Remote Utilization Management experience at Payors, inpatient or outpatient - ... Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients.… more
- University of Virginia (Charlottesville, VA)
- Inpatient and Outpatient Setting. Under general direction: The Utilization Management RN serves as a leader resource in the Utilization Management process. They ... RN conducts initial concurrent and retrospective medical necessity reviews. All Utilization Management activities are performed in accordance with the mission vision… more
- Centene Corporation (Tallahassee, FL)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... perspective on workplace flexibility. NOTE: This is a fully remote role assisting providers by reviewing requests for authorization;...based care such as IOP or PHP, and (4) utilization management / review . **Position Purpose:** Performs… more
- Children's Hospital Boston (Boston, MA)
- 76071BRJob Posting Title:RN Case Manager, Utilization Review , Case Management UM/UR (24 hrs)Department:Patient Services-Patient Care ... OperationsAutoReqId:76071BRStatus:Part-TimeStandard Hours per Week:24 Job Posting Category:NursingJob Posting Description:The Utilization Review Nurse will be responsible for:… more
