- Mohawk Valley Health System (Utica, NY)
- Registered Nurse - Utilization Review Nurse - Full Time - Days Department: CASE MANAGEMENT Job Summary Reports to and is under direct supervision of ... compliance. Education/Experience Requirements Required: + Minimum of two (2) years utilization review /case management experience or social work experience.… more
- Trinity Health (Springfield, MA)
- …determinations using screening criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization management and clinical ... **Shift:** Rotating Shift **Description:** Requires BSN At **Mercy Medical Center** the ** Utilization Review /Appeals & Denials** **RN** performs utilization … more
- Ascension Health (Destin, FL)
- **Details** + **Department: Utilization Review ** + **Schedule: 3 (8) hour days per week Monday-Friday** + **Hospital: Ascension Sacred Heart Emerald Coast** + ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… 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 (Ann Arbor, MI)
- **Employment Type:** Part time **Shift:** **Description:** **POSITION PORPOSE** + The Utilization Review Specialist is responsible for facilitating collection of ... clinical, age specific, developmental, cultural and spiritual needs. Facilitates utilization management documentation and appropriate communication with external agencies.… more
- LifePoint Health (Danville, VA)
- * Registered Nurse , RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** Must ... have Utilization Review experience.** ** * ** *Your...valued as an employee, but as a person. As a* registered nurse (RN)*joining our team, you're embracing… more
- Trinity Health (Syracuse, NY)
- …**Shift:** Day Shift **Description:** $10,000 NEW HIRE SIGN ON BONUS **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
- Emory Healthcare/Emory University (Atlanta, GA)
- …programs + And more **Description** **Remote Position** We're seeing an **Assistant Manager, Utilization Review ( Registered Nurse / RN)** responsible ... for supervising and coordinating activities of personnel in the Utilization Review Department, including staff schedules to ensure appropriate department… 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
- Health Advocates Network (Medford, OR)
- … Review experience. * Pay Rate: $2,608 weekly * Specialty: Discharge Planning and Utilization Review Registered Nurse (RN) * Shift: Day * 13 ... School of Nursing * 2 years of experience as a Discharge Planning and Utilization Review Registered Nurse (RN) * American Heart Association BLS *… 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 ... testing along with determining medical necessity of patient while hospitalized. Our Utilization Review RN will be part of an excellent team of Case Management… 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
- Ascension Health (Tulsa, OK)
- …initiatives. + Develop systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to ... codes for all clients. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing obtained… 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 $118,161.60 -… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001 Location East Hartford, CT Date Opened 11/7/2024 12:00:00 AM ... (https://portal.ct.gov/dds/searchable-archive/northregion/north-region/welcome-to-the-north-region?language=en\_US) - is accepting applications for a full-time Utilization Review Nurse Coordinator… more
- University of Virginia (Charlottesville, VA)
- …2 years acute care hospital experience. Licensure: Licensed to Practice as a Registered Nurse in the Commonwealth of Virginia required. PREFERRED QUALIFICATIONS: ... Under general direction: The Utilization Management RN serves as a leader resource...in determining what cases to refer for second level review to external physician consultants and internal UVA UR… 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
- 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
- Dayton Children's Hospital (Dayton, OH)
- Facility:Work From Home - OhioDepartment: Utilization Review TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization ... Management, the Utilization Review RN conducts medical record review for medical necessity and level of care using nationally recognized acute care… more
- Travelers Insurance Company (Albany, 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