- 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
- University of Washington (Seattle, WA)
- …) **UW Medical Center** has an outstanding opportunity for an **experienced Utilization Review Nurse (UM RN )** to join our team. **WORK SCHEDULE** + ... Req #: 236354 Department: UW MEDICAL CENTER - UTILIZATION MANAGEMENT Job Location Detail: Position supports both...and training + Active licensure to practice as a Registered Nurse in Washington State required by… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse or Licensed Practical Nurse...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization… more
- 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
- 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
- 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
- UPMC (Hanover, PA)
- …required with 4-6 weeks of hire. UPMC approved Care Management certification preferred. + Registered Nurse ( RN ) + Act 34 *Current licensure either in ... hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is...preferred. **Licensure, Certifications, and Clearances:** Current licensure as a Registered Professional Nurse either in the state… 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
- 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
- Baptist Memorial (Jackson, MS)
- Summary The Utilization Review Nurse is...+ Employee referral program Job Summary: Position: 19738 - RN - Utilization Review Facility: MBMC - ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...Hospital Department: HS Case Mgmt Administration Corporate Category: Nurse RN Type: Clinical Work Type: Full… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… 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
- 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
- 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
- Community Health Systems (Milton, FL)
- …efficiency and overall effectiveness. + Oversight and evaluation of the discharge planner/ utilization review nurse . + Perform and oversee needs analysis ... + Florida RN License-active + Case Management experience 2+ years + Utilization review experience 2+ years + Knowledgeable of resident's financial status,… more
- Humana (Baton Rouge, LA)
- …Provider calls **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) compact license with no disciplinary action ... independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review Post-Acute Preauth cases using… more