• System Manager- Utilization Review

    Baptist Memorial (Memphis, TN)
    …federal and other payer requirements. RN , Nurse , Registered Nurse Responsibilities ? Monitors and completes utilization review processes ? ... of clinical experience at least 2 of which involve Utilization Review or Case Management Preferred- RN... RN , Nurse , Registered Nurse Responsibilities ? Monitors and completes utilization more
    Baptist Memorial (03/14/25)
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  • Utilization Review Nurse

    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 $118,457.04 -… more
    The County of Los Angeles (12/29/24)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Queens Village, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Creedmoor Psychiatric Center, P25684 Occupational Category Health ... City Queens Village State NY Zip Code 11427 Duties Description As a Utilization Review Coordinator, your duties will include:* Reviewing clinical records for… more
    New York State Civil Service (03/12/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Bronx, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational ... New York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… more
    New York State Civil Service (03/04/25)
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  • Utilization Review Coord

    Covenant Health Inc. (Louisville, TN)
    …Current RN or Therapy license. RN License Apply/Share Job Title UTILIZATION REVIEW COORD ID 4182116 Facility Peninsula, a Division of Parkwest Medical ... Overview Utilization Review Coordinator, Quality Management Full...Performs other related duties as required. Qualifications Minimum Education: RN License or Licensed Therapist from an accredited program… more
    Covenant Health Inc. (01/31/25)
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  • Licensed Practical Nurse (LPN)…

    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
    The Arora Group (02/20/25)
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  • Utilization Review Nurse

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

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

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse ( RN ) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse ( RN...Holidays (Outlined in Handbook) + 401(k) Plan Minimum Requirements Registered Nurse ( RN ) Utilization more
    Matrix Providers (01/29/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
    Beth Israel Lahey Health (02/09/25)
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  • Director - Utilization Review

    Ochsner Health (New Orleans, LA)
    …or acute care setting, including 3 years of leadership experience **Certifications** Required - Registered Nurse ( RN ) license in the state of practice ... and conflict resolution skills. **Job Duties** + Lead and directs Utilization Review (UR) staff and functions, including staffing, staff engagement, training,… more
    Ochsner Health (01/29/25)
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  • Utilization Review Specialist - PRN

    Munson Healthcare (Traverse City, MI)
    …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
    Munson Healthcare (02/07/25)
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  • 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,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (02/08/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
    Beth Israel Lahey Health (01/29/25)
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  • 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 ... resources as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of… more
    Chesapeake Regional Healthcare (02/16/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Lexington, KY)
    …1. Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted ... for appropriate status determination. 2. Ensures compliance with principles of utilization review , hospital policies and external regulatory agencies, Peer… more
    Catholic Health Initiatives (03/04/25)
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  • Utilization Review Nurse

    Independent Health (Buffalo, NY)
    …perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review ... required; Bachelor's degree preferred. Current, active, unrestricted, and licensed registered nurse ( RN ) required. +... in a varied clinical setting required. + Previous utilization review experience preferred. + Previous experience… more
    Independent Health (03/14/25)
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  • Utilization Review RN (1.0…

    St. Peters Health (Helena, MT)
    The Utilization Management Nurse reports directly to Utilization Review RN Coordinator. The UR Nurse supports the UR RN Coordinator in ... utilization functions for the organization and is responsible for ensuring complaint utilization and cost-effective care delivery. The UR Nurse is responsible… more
    St. Peters Health (02/15/25)
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  • Utilization Review Nurse

    Dignity Health (Chandler, AZ)
    …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
    Dignity Health (03/13/25)
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  • RN - Utilization Review

    Baptist Memorial (Memphis, TN)
    Overview  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 ...+ Employee referral program Job Summary: Position: 19737 - RN - Utilization Review Facility: BMHCC Corporate… more
    Baptist Memorial (03/14/25)
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