- Bluestone Child & Adolescent Psychiatric Hospital (University Heights, OH)
- …skills. Experience: A minimum of 1 year experience as a psychiatric nurse . 1-2 years-experience in behavioral health utilization review preferred. AGENCY ... Psychiatric Intake Nurse - FT Nights, 5-8 hour shifts- Sunday through...or LPN degree. Bachelor's or Master's degree in related field preferred. Licensure: Valid Ohio RN/LPN license required. Skills:… more
- Centene Corporation (Columbus, OH)
- …, InterQual knowledge, and discharge planning.** **Additional Details:** Department: Concurrent Review MCD** Business Unit: Corporate** Schedule: Monday-Friday ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …on Service Connection (SC), non-SC, Special Authority (SA), precertification, prospective review , concurrent review , denial management, retrospective ... Summary The Revenue Utilization Review (RUR) nurse is under the...Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing… more
- Dignity Health (Gilbert, AZ)
- …the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
- Centene Corporation (Jefferson City, MO)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... on workplace flexibility. **Position Purpose:** Performs a clinical retrospective review and assessment of complex services previously provided to determine… more
- Centene Corporation (Jefferson City, MO)
- …providers, as appropriate, for any discrepancies between prior authorization and concurrent review processes to ensure clinically appropriate determinations + ... perspective on workplace flexibility. **Position Purpose:** Performs a clinical retrospective review of services previously provided to determine if the level of… more
- Prime Healthcare (Mount Prospect, IL)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... post-graduation of an accredited school of nursing and a current state Registered Nurse license 2. Grandfathered prior to April 1, 2015. Minimum 5 years post… more
- Sacramento County (Sacramento, CA)
- Nurse Practitioner Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/1780920) Apply Nurse Practitioner Salary $132,483.60 - $161,026.56 ... 9/26/2025, 10/24/2025, 11/26/25, 12/26/25, 1/23/26, 2/27/26, 3/27/26, 4/24/26, 5/22/26, 6/26/26 Nurse Practitioners provide a range of health care services involving… more
- Sacramento County (Sacramento, CA)
- Supervising Public Health Nurse Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/600083) Apply Supervising Public Health Nurse Salary ... the operations, program, and personnel of a public health field office staffed by professional nurses, health workers and...One year of experience as a Senior Public Health Nurse in Sacramento County service. Or: Two years of… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse D/CF Salary ... on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory class in… more
- Vitalief (Philadelphia, PA)
- …and grow sustainably. The Role We are seeking an experienced Clinical Research Nurse to join our exceptional team as a full-time Vitalief employee. In this ... will support the planning, implementation, and execution of multiple concurrent clinical research studies, including NIH-sponsored, industry-sponsored, and investigator-initiated… more
- BrightSpring Health Services (Mount Laurel, NJ)
- …Registered Professional Nurse + Excellent communicator with ability to handle concurrent tasks and responsibilities + Ability to travel within assigned area + ... adults with intellectual and developmental disabilities. + Supervises a team of field -based travel nurses (LPNs) in the performance of clinical duties. + Provides… more
- Prime Healthcare (Riverdale, GA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Experience Required qualifications: 1. BSW or other Bachelor degree in a related field . At least one year experience in case management, discharge planning or… more
- Prime Healthcare (East Liverpool, OH)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... Qualifications Required qualifications: 1. BSW or other Bachelor degree in a related field . At least one year experience in case management, discharge planning or… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work onsite. ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include supervising staff… more
- Centene Corporation (Atlanta, GA)
- …medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Nuvance Health (Danbury, CT)
- …payers. * If concurrent inpatient case does not meet medical necessity review criteria during the first level review , discuss with the attending MD ... Days, Evenings, Nights available* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within… more
- Trinity Health (Syracuse, NY)
- …administrative requirements for Utilization Management and works collaboratively with Utilization Management/ Concurrent Review Nurse , physicians, staff and ... possible concurrent denials, forwards information to the appropriate Utilization Management/ Concurrent Review Nurse within identified process standards *… more
- University of Southern California (Alhambra, CA)
- …of the major duties of the Case Manager overlap into inpatient duties including: Concurrent review of all patients to validate that the appropriate patient ... MCG competency testing. 8. Perform telephonic, and if appropriate, on-site initial/ concurrent review on identified in-patient members. Direct pertinent clinical… more
- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical ... between utilization management team, members, and providers + Monitors prior authorization, concurrent review , and/or retrospective clinical review nurses… more
