- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,161.60 -… 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
- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Utilization Review Nurse - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of ... compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work experience.… more
- Pipeline Health System, LLC (Toast, NC)
- …- Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse ( RN ) position supports the Mission of Pipeline Health ... Job Title: Utilization Review Registered ...care to our patients. This position is responsible for utilization review , assessment of discharge planning needs… more
- 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...BSN or MSN degree, required * Current valid California RN license, required * Two or more years of… 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
- Dayton Children's Hospital (Dayton, OH)
- …timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical record review for ... medical guidelines and communicates information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource to the… more
- US Tech Solutions (Chicago, IL)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
- Travelers Insurance Company (Albany, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**...assigned state preferred. **What is a Must Have?** + Registered Nurse ; Licensed Practical Nurse … more
- US Tech Solutions (May, OK)
- …of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1...months of Prior Authorization. Education: . Active and unrestricted RN licensure in state of residence **About US Tech… more
- 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 ... the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech… more
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is...+ Employee referral program Job Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...Hospital Department: HS Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: Full… more
- Providence (Kodiak, AK)
- …procedures and standards. The Case Manager/ RN Navigator partners with the Utilization Review nurse , patients, physicians, and interdisciplinary team to ... + Associate's Degree in Nursing + Upon hire: Alaska Registered Nurse License + 3 years Clinical...+ Bachelor's Degree + 1 year experience as an RN in Utilization Management- review , Case… more
- Health Advocates Network (Medford, OR)
- …Review experience. * Pay Rate: $2,608 weekly * Specialty: Discharge Planning and Utilization Review Registered Nurse ( RN ) * Shift: Day * 13 Week ... of Nursing * 2 years of experience as a Discharge Planning and Utilization Review Registered Nurse ( RN ) * American Heart Association BLS * An active,… more
- LifePoint Health (Hancock, MI)
- …growth of our employees both professionally and personally. We are seeking a detail-oriented Utilization Review Registered Nurse to be responsible for ... outpatient testing along with determining medical necessity of patient while hospitalized. Our Utilization Review RN will be part of an excellent team of… more
- Commonwealth of Pennsylvania (PA)
- …I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or ... + Questions THE POSITION If you are a compassionate registered nurse seeking to advance your career,...Work Behavior as a charge nurse , head nurse , utilization review nurse… more
- Dayton Children's Hospital (Dayton, OH)
- …years of acute care experience in a hospital required + 3-5 years as progressive utilization review nurse and knowledge of payers and managed care contracts ... Coaching Skills preferred Education Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN : Registered Nurse ( RN ) -… more
- Trinity Health (Springfield, MA)
- …program. BSN graduate preferred, Master's preferred + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... Shift **Description:** Requires BSN At **Mercy Medical Center** the ** Utilization Review /Appeals & Denials** ** RN **...criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization … more
- Humana (Boise, ID)
- …Provider calls **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the appropriate state, with no ... independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review cases using clinical knowledge,… more
- AdventHealth (Glendale Heights, IL)
- …required. + Behavioral Health RN experience strongly preferred + Experience in utilization review strongly preferred + Registered Nurse credentialed ... health care services regarding admissions, case management, discharge planning and utilization review . **The value you'll bring to the team:** + Reviews… more
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