- 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
- Mohawk Valley Health System (Utica, NY)
- RN - Utilization Review Nurse - Full Time - Days Department: CASE MANAGEMENT Job Summary The RN - Utilization Management gathers clinical ... advisors as needed to appeal concurrent UR denials. + Complete daily utilization review of all observation/outpatient/in-bed patients. Collaborate with Care… more
- 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
- 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
- MetroHealth (Cleveland, OH)
- …patient care by ensuring the appropriate level of care at the point of entry. The utilization review nurse will work on defined patient populations and is ... degree in Nursing (applies to placements after 1/1/2017). Current Registered Nurse License State of Ohio. Minimum...skills. Preferred: Two years of experience with case management, utilization review . Physical Demands: May need to… more
- Centene Corporation (New York, NY)
- …**Must have a New York State license or identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a ... Summary The Revenue Utilization Review (RUR) nurse ...processes and under moderate supervision and instruction by the registered nurse manager Responsibilities of the RUR… 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
- 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 (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
- 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
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager...Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review… more
- 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
- 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
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of...Or + Associate's Degree Nursing + 3 years of Utilization Review , Care Management, Quality Management, and/or… 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
- Lowe's (Charlotte, NC)
- …in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in a clinical ... for medically managing a minimum caseload of 65 including review of claims identified for Medicare Set-Aside. **What you...- Certified Case Manager + CRRN - Certified Rehabilitation Registered Nurse + CDMS - Certified Disability… more
- Bitterroot Health (Hamilton, MT)
- …Hamilton, Montana!! Bitterroot Health is seeking candidates to fill a Utilization Review (UR) Coordinator Registered Nurse position. The UR Coordinator ... & 2023 State of Montana "EMPLOYER OF CHOICE" 2022 RN - Utilization Review Coordinator...to Case Management, coding and/or billing preferred. + Certifications: RN licensure in the State of Montana or CCS,… more