- Kelsey-Seybold Clinic (Pearland, TX)
- …of communication with clinic, payor and other customers. **Job Title: Licensed Vocational Nurse Utilization Review -** ** Utilization Management--Sign on ... **Responsibilities** The Utilization Review LVN nurse will perform documentation review for medical necessity and benefit correlation of requested… 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 ... in Nursing (applies to placements after 1/1/2017). Current Registered Nurse License State of Ohio. Minimum of five years...skills. Preferred: Two years of experience with case management, utilization review . Physical Demands: May need to… 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 ... 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 240830-5613FP-001 Location Middletown, CT Date Opened 9/5/2024 12:00:00 AM Salary ... Hospital - is accepting applications for one (1) full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in ... will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. **Title: Utilization Review Nurse ** **Location: Hospital Client ... 11a-7p EST. Hours may vary and some flexibility may be offered** As our ** Utilization Review Nurse ** , you will help our hospital clients by working… 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 ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …+ Adaptive to a high pace and changing environment. + Proficient in Utilization Review process including benefit interpretation, contract language, medical and ... Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs daily medical necessity reviews. This position… more
- US Tech Solutions (Chicago, IL)
- …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Ascension Health (Birmingham, AL)
- …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 (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
- Ascension Health (Tulsa, OK)
- …planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance ... at time of hire. **Additional Preferences** + Experience with Interqual preferred + Utilization Review experience preferred + 3+ years of bedside nursing **Why… more
- UNC Health Care (Rocky Mount, NC)
- …Carolina license without sanctions)** Preferred Certifications & Licensures + Utilization Review or other applicable certification **Professional Experience ... - acute care (acute hospital setting) + 0-2 healthcare/medical - - utilization review (or other healthcare-related experience) Preferred Experience: +… 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 ... for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization… 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 (RN) ... compassionate care to our patients. This position is responsible for utilization review , assessment of discharge planning needs and coordination of effective… 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 ... do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- US Tech Solutions (May, OK)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ..... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
- ERP International (Corpus Christi, TX)
- …range of utilization management services including referrals, care coordination, utilization review , discharge planning, continued stay reviews, and appeal ... **Overview** ERP International is seeking a **Registered Nurse (RN)** ** Utilization Manager** for a full-time position in support of the **Naval Health Clinic… 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 ... quality, cost effective outcomes. 50% Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and… more