- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Intermountain Health (Murray, UT)
- …discharge planning efforts, coordination of transition of care and manage utilization through appropriate review of authorization requests. Job Essentials ... **Job Description:** Proactively manage inpatient and outpatient utilization to assure that medical care is appropriate, efficient, and medically necessary. Support… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse ... compassionate care to our patients. This position is responsible for utilization review , assessment of discharge planning needs and coordination of effective… more
- Trinity Health (Syracuse, NY)
- …days shift with every 6th weekend. Med Surg experience preferred. **Position Purpose:** The Registered Nurse Utilization Review (UR), Clinical Care ... Manger (CCM) actively manages the utilization review process and patient progression from...to all patients in accordance with the New York Nurse Practice Act, National Standards of Practice, and Nursing… more
- The Arora Group (Bethesda, MD)
- …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse (RN) and pre-certification ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in… more
- McLaren Health Care (Bay City, MI)
- …management to expedite patient discharge. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... degree from an accredited educational institution + State of Michigan licensure as a Registered Nurse (RN) + Two years of recent clinical or utilization… more
- HCA Healthcare (Nashville, TN)
- …want your knowledge and expertise! **Job Summary and Qualifications** **As a Utilization Review Services Registered Nurse , you will focus on initial and ... **Description** **Introduction** Do you have the career opportunities as a(an) Utilization Review Nurse BH WFH you want with your current employer? We have… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse (RN)** ** Utilization Manager** for a full-time position in support of the **Naval Health ... range of utilization management services including referrals, care coordination, utilization review , discharge planning, continued stay reviews, and appeal… more
- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... + EDUCATION / CERTIFICATION / LICENSURE + Required: + Currently licensed as a Registered Professional Nurse in New York State. + Associates Degree + Preferred:… more
- McLaren Health Care (Detroit, MI)
- …accordance with established SOP procedures. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... **Department: Utilization Management** **Daily Work Times: 7:00am-3:30pm** **Shift: Days**...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** Utilization Management Nurse - Weekend Front End Review utilizes clinical nursing skills to support ... Go365 perks for well-being The Utilization Management Nurse - Weekend Front End Review uses...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in Florida with no… more
- 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 $113,309.04 -… more
- New York State Civil Service (Malone, NY)
- NY HELP Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 2 - Utilization Per Diem - NY HELPS Occupational Category ... Possession of a license and current registration as a registered professional nurse in New York State;...clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's… 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
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. **Title: Utilization Review Nurse ** **Location: Hospital Client ... vary and some flexibility may be offered** As our ** Utilization Review Nurse ** , you...other opportunities that promote growth. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Independent Health (Buffalo, NY)
- …first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Utilization Review Nurse performs clinical reviews to determine ... criteria or IHA policy. **Qualifications** + Active, current, unrestricted, and licensed registered nurse required. Associates degree in health related field;… more
- US Tech Solutions (Chicago, IL)
- …you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About ... + 3+ years of experience as an RN + Registered Nurse in state of residence +...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... Minimum of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
- Travelers Insurance Company (Buffalo, 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