• 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 $118,161.60 -… more
    The County of Los Angeles (12/29/24)
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  • Utilization Review Nurse (40…

    State of Connecticut, Department of Administrative Services (Hartford, CT)
    Utilization Review Nurse (40 Hour)...+ + + + Introduction Are you a skilled Registered Nurse ( RN )? Join our team ... and Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) !… more
    State of Connecticut, Department of Administrative Services (01/08/25)
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  • Temporary Utilization Review

    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
    Martin's Point Health Care (01/08/25)
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  • Utilization Review Nurse

    Independent Health (Buffalo, NY)
    …enjoying first-class perks, benefits and commitment to diversity and inclusion. **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 (01/10/25)
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  • RN - Utilization Review

    Glens Falls Hospital (Glens Falls, NY)
    …be foundhere. **Job:** **Nursing - Case Management* **Title:** * RN - Utilization Review Nurse * **Location:** *NY-Glens Falls* **Requisition ID:** *2410V* ... acute care, utilization management, or payer experience preferred. *Licenses/Certifications/Registrations* * ** Registered Nurse ( RN ) in New York State* *… more
    Glens Falls Hospital (12/19/24)
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  • Utilization Review Nurse

    US Tech Solutions (Canton, MA)
    …but required** **unrestricted MA license** **Overview:** We are seeking an experienced ** Utilization Review Nurse ** to provide clinically appropriate and ... mentorship and participate in special projects as assigned. **Qualifications:** + **Education:** Registered Nurse ( RN ) with a current, unrestricted **MA… more
    US Tech Solutions (01/09/25)
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  • Utilization Review Nurse

    BayCare Health System (Clearwater, FL)
    …team member be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Nurse - Health Plan **Location** ... Qualifications:** **Education:** + Associates Degree - Nursing **Credentials:** + RN License **Experience:** + 2 years - Case Management...2 years - Case Management + 2 years - Utilization Review + Managed care strongly preferred… more
    BayCare Health System (12/05/24)
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  • Utilization Review Nurse

    Catholic Health Initiatives (Little Rock, AR)
    …Matching 401(k) and 457(b) Retirement Programs Wellness Programs. **Responsibilities** The Utilization Review Nurse coordinates the communication of ... cost effective use of available resources. The care manager utilization review will monitor the changes in...update the payer on changes in the patients **Qualifications** Registered Nurse with Bachelors degree or diploma/associates… more
    Catholic Health Initiatives (01/11/25)
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  • 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...BSN or MSN degree, required * Current valid California RN license, required * Two or more years of… more
    UCLA Health (01/08/25)
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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 (11/22/24)
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  • Utilization Review Nurse

    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
    US Tech Solutions (10/18/24)
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  • Utilization Review Nurse

    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 (10/18/24)
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  • Utilization Review Nurse

    CVS Health (Phoenix, AZ)
    …first 3 weeks training with 100% participation during 8:30am-5pm Monday-Friday EST + A Registered Nurse that must hold an unrestricted license in their state of ... and some rotational on-call holiday coverage (URAC and Client Requirements). Utilization Management is a 24/7 operation.** 100% attendance is required during… more
    CVS Health (01/10/25)
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  • 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 ... 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
    US Tech Solutions (12/20/24)
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  • Utilization Review Nurse

    Prime Healthcare (Aurora, IL)
    …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189384/ utilization - review - nurse ... or payer setting within the last 5 years. 2. Utilization review and denial management experience required.... and denial management experience required. 3. Current state RN licensure required. 4. Must be able to communicate… more
    Prime Healthcare (01/11/25)
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  • RN - Utilization Review

    Baptist Memorial (Memphis, TN)
    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 (12/03/24)
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  • RN - Utilization Review

    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
    Health Advocates Network (11/09/24)
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  • Utilization Review RN

    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
    LifePoint Health (01/09/25)
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  • Utilization Review RN

    Swedish Health Services (Seattle, WA)
    …** 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....an accredited school of nursing. + Upon hire: Washington Registered Nurse License + 3 years Med/Surg… more
    Swedish Health Services (12/31/24)
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  • RN Registered Nurse

    Ascension Health (Wamego, 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
    Ascension Health (01/09/25)
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