• Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...$176,872.80 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening… more
    The County of Los Angeles (12/29/24)
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  • Sr Utilization Review Spec FT Humc

    Hackensack Meridian Health (Hackensack, NJ)
    **Overview** **The Utilization Review Physician collaborates with the healthcare team in the** **management and resolution of activities that assure the ... population and Hackensack UMC. These include but are not limited to utilization review ,** **hospital reimbursement, clinical compliance, case management, and… more
    Hackensack Meridian Health (11/02/24)
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  • Utilization Review RN

    Beth Israel Lahey Health (Boston, MA)
    …a difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining ... **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of...billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review more
    Beth Israel Lahey Health (12/12/24)
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  • Utilization Review Admission…

    Mount Sinai Health System (New York, NY)
    …Admission Specialist (OR Scheduler), Operating Room Surgical Scheduling, Mount Sinai West - Full Time, Days** The Utilization Review Specialist coordinates ... testing and operating roaom time. 7. Checks credentials system for physician 's delineation of privileges for equipment and/or procedures according to medical… more
    Mount Sinai Health System (12/04/24)
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  • Utilization Review Case Mgr-…

    UTMB Health (Webster, TX)
    Utilization Review Case Mgr- CMC-Clear Lake Center - shift 3:00 PM-11:00 PM - Monday-Friday **Webster, Texas, United States** **New** Nursing & Care Management ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
    UTMB Health (01/14/25)
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  • Utilization Review RN

    Dignity Health (Mesa, AZ)
    …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... emergency room beds, four operating or procedure rooms, a full onsite laboratory and radiology suite complete with 64...admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the… more
    Dignity Health (01/24/25)
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  • RN Utilization Review Specialist

    HonorHealth (Scottsdale, AZ)
    …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... want to make an impact. HonorHealth offers a diverse benefits portfolio for our full -time and part-time team members designed to help you and your family live your… more
    HonorHealth (12/03/24)
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  • 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...necessity or other areas when indicated + Communicates with physician advisors related to status concerns or denials +… more
    Baptist Memorial (01/16/25)
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  • RN - Utilization Review *DAYS

    Providence (Olympia, WA)
    **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management ... Or + Associate's Degree Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or...in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska,… more
    Providence (01/22/25)
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  • Utilization Review RN

    Providence (Everett, WA)
    …years, OR recent Utilization Management experience **Preferred Qualifications:** + Utilization review or case management experience + Experience with ... **Description** Oversee utilization management and review of patients...in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska,… more
    Providence (01/22/25)
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  • Utilization Review RN

    Swedish Health Services (Seattle, WA)
    **Description** ** Utilization Review RN** ** Full time 1 FTE** **Day Shift** The Utilization Review (UR) Nurse has a strong clinical background ... blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination....in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska,… more
    Swedish Health Services (01/16/25)
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  • Insurance Verification and Utilization

    Community Health and Counseling Services (Bangor, ME)
    Insurance Verification and Utilization Review Specialist - Health Services Job Type(s): Full -Time Location(s):Bangor, Maine Education:Associates Degree - ... collaborating with Agency staff, patients, family members, facilities and physician . Responsible for utilization management of services, verifying… more
    Community Health and Counseling Services (01/08/25)
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  • Medical Director: Documentation…

    Trinity Health (Boise, ID)
    …level reviews for patients not meeting inpatient criteria. C. Participates in local Utilization Review Committee and be a member of appropriate committees and ... **Work Experience** **Job Description:** Saint Alphonsus is seeking a physician leader to become our Medical Director of Documentation...accurate reporting of bed status. F. Assist case managers, utilization review nurses and social workers to… more
    Trinity Health (01/12/25)
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  • RN Utilization Manager - Rex Case…

    UNC Health Care (Raleigh, NC)
    **Description** ** Full time exempt, 40 hours per week Utilization Manager - Medical necessity review for Surgical admissions** Become part of an inclusive ... episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to… more
    UNC Health Care (01/15/25)
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  • Utilization Management RN

    AdventHealth (Daytona Beach, FL)
    …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... status conflict is indicated, the UM nurse is responsible for escalation to the Physician Advisor or designated leader for additional review as determined by… more
    AdventHealth (01/23/25)
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  • Care Coordinator, Utilization Management

    Hackensack Meridian Health (Neptune, NJ)
    …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
    Hackensack Meridian Health (01/17/25)
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  • Care Coordinator, Utilization Management

    Hackensack Meridian Health (Holmdel, NJ)
    …at Hackensack Meridian _Health_ includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted… more
    Hackensack Meridian Health (11/14/24)
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  • Utilization Management Representative

    Kelsey-Seybold Clinic (Pearland, TX)
    …all units within the Utilization Management and/or Population Health Department. ( Utilization Review , Concurrent Review , Population Health and Case ... Title: Utilization Management Representative** **Location:** **Remote** **Department:** ** Utilization Management** **Job Type: Full Time** **Salary Range:… more
    Kelsey-Seybold Clinic (01/23/25)
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  • Administrative Assistant - Utilization

    Swedish Health Services (Seattle, WA)
    …(all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, ... and specialty care locations throughout the Puget Sound. Whether through physician clinics, education, research and innovation or other outreach, we're dedicated… more
    Swedish Health Services (01/22/25)
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  • Utilization Management Specialist - RN…

    Cleveland Clinic (Weston, FL)
    …patient's hospital stay or visit. Some of the responsibilities of a Utilization Management Specialist include medical record review , providing clinical ... Utilization Management Specialist Join Cleveland Clinic Weston Hospital's...Management (UM) Specialists perform UM activities, such as admission review , concurrent review , retrospective chart review more
    Cleveland Clinic (01/23/25)
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