• Utilization Review Nurse

    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
    The County of Los Angeles (12/29/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse (RN)

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team of talented… more
    Matrix Providers (01/29/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    MetroHealth (Cleveland, OH)
    …patient care by ensuring the appropriate level of care at the point of entry. The utilization review nurse will work on defined patient populations and is ... in Nursing (applies to placements after 1/1/2017). Current Registered Nurse License State of Ohio. Minimum of five years...skills. Preferred: Two years of experience with case management, utilization review . Physical Demands: May need to… more
    MetroHealth (02/01/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (01/24/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse (RN)

    Community Health Systems (Naples, FL)
    …Under the direction of the Utilization Review (UR) Director/Manager the Utilization Review (UR) Nurse reviews all admissions for medical necessity, ... Bachelor's Degree BSN required + 2-4 years clinical practice experience required + Utilization Review experince preferred + Experience in HEDIS, MIPS, PQRS, ACO,… more
    Community Health Systems (01/31/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management & Quality…

    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
    UCLA Health (01/08/25)
    - Save Job - Related Jobs - Block Source
  • Licensed Practical Nurse (LPN)…

    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 Arora Group (11/22/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    Beth Israel Lahey Health (Burlington, MA)
    …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
    Beth Israel Lahey Health (02/14/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    Beth Israel Lahey Health (Burlington, MA)
    …Rotation **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
    Beth Israel Lahey Health (02/14/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    University of Utah Health (South Salt Lake, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (02/08/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    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
    US Tech Solutions (01/17/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    Actalent (Nashville, TN)
    Actalent is Hiring a Team of Post Acute Utilization Review Nurses - Open to both RNs and LPNs! - Remote! This is a Monday to Friday 10am - 7pm CST (No weekends ... and Start Date of 3/24!! Job Description The PAC Nurse is a telephonic position responsible for recommending discharge... experience and/or discharge planning. + 2 years of utilization review /management experience. + 1 year of… more
    Actalent (02/15/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    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
    US Tech Solutions (01/17/25)
    - Save Job - Related Jobs - Block Source
  • Professional Care Manager Utilization

    UPMC (Hanover, PA)
    **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... the clinical and financial plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care referrals… more
    UPMC (01/24/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    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
    US Tech Solutions (12/20/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Nurse / Care…

    Children's Hospital Los Angeles (Los Angeles, CA)
    …of healthcare services provided to all admitted patients. Using a value-based approach the Utilization Review Nurse ensures that care is administered via ... of California **Purpose Statement/Position Summary:** The Utilization Nurse is responsible for utilization review... Utilization Nurse is responsible for utilization review including medical necessity, appropriateness, and… more
    Children's Hospital Los Angeles (02/11/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager with Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
    Beth Israel Lahey Health (02/09/25)
    - Save Job - Related Jobs - Block Source
  • RN, Utilization Review Flexi

    Chesapeake Regional Healthcare (Chesapeake, VA)
    Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization ... as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical… more
    Chesapeake Regional Healthcare (02/16/25)
    - Save Job - Related Jobs - Block Source
  • RN- Utilization Review - HS Case…

    Baptist Memorial (Jackson, MS)
    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 Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate… more
    Baptist Memorial (02/17/25)
    - Save Job - Related Jobs - Block Source
  • LVN - Quality Assurance/ Utilization

    Emanate Health (Covina, CA)
    …the United States, and the #19 ranked company in the country. **Job Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices....support and review of medical claims and utilization practices. Complete medical necessity and level of care… more
    Emanate Health (01/22/25)
    - Save Job - Related Jobs - Block Source