• Utilization Review Nurse

    Adecco US, Inc. (Houston, TX)
    …$85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . ** Review Medical Records:** Thoroughly evaluate patient medical ... & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston,...of treatments and services. . **Conduct Audits:** Regularly audit medical records and healthcare practices to ensure compliance with… more
    Adecco US, Inc. (05/01/25)
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  • Registered Nurse (RN) - Utilization

    LifePoint Health (Las Cruces, NM)
    …in employment." **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** *Registered Nurse (RN) - Utilization Review - Full Time* ... *Your experience matters* At Memorial Medical Center, we are driven by a profound...an employee, but as a person. As a registered nurse (RN) joining our team, you're embracing a vital… more
    LifePoint Health (04/28/25)
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  • Licensed Practical Nurse (LPN)…

    The Arora Group (Bethesda, MD)
    Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW :...clinical information and may also provide education on the medical review process. + The Contractor performing… more
    The Arora Group (02/20/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… more
    The County of Los Angeles (03/30/25)
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  • Utilization Review Nurse (RN)

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... experience lower provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team of… more
    Matrix Providers (04/29/25)
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  • Utilization Review Nurse

    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 ... 8a-430p varied days, EO/ WE+Hol About Us Milford Regional Medical Center is a full-service, community and regional teaching...Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including… more
    Milford Regional Medical Center (04/29/25)
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  • Utilization Review Nurse

    Beth Israel Lahey Health (Burlington, MA)
    …care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission… more
    Beth Israel Lahey Health (02/14/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... improvement in both areas.* Refers cases and issues to Medical Director and Triad Team in compliance with Department...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
    Albany Medical Center (04/25/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (05/03/25)
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  • RN / Nurse Utilization Review

    Elevance Health (Woodbridge, VA)
    RN Utilization Review Nurse (Washington DC...609 H. Street NE. The ** Medical Management Nurse ** is responsible for review of the most ... whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
    Elevance Health (05/03/25)
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  • Utilization Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    review programs and key performance indicators for all utilization review activities. + Interact with medical , nursing, and executive leadership to ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
    Ascension Health (03/26/25)
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  • Registered Nurse Care Manager…

    Catholic Health (Buffalo, NY)
    …with Weekend and Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager- Utilization Review , as an active member of the ... Care Management and interdisciplinary care team, provides comprehensive Utilization Review and discharge services to patients...Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New… more
    Catholic Health (05/01/25)
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  • Utilization Review Nurse

    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 ... Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization more
    CDPHP (05/01/25)
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  • Utilization Management Review

    AmeriHealth Caritas (Dover, DE)
    …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday,… more
    AmeriHealth Caritas (04/29/25)
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  • Behavioral Health Utilization Review

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current employer? We ... Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for...and productivity. **In this role you will:** + Conduct medical record review , validate admission status order,… more
    HCA Healthcare (04/25/25)
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  • Registered Nurse - Utilization

    Ascension Health (Baltimore, MD)
    …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (05/03/25)
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  • Utilization Review Nurse

    Dignity Health (Gilbert, AZ)
    …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
    Dignity Health (04/04/25)
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  • Professional Care Manager Utilization

    UPMC (Hanover, PA)
    **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... the clinical and financial plan for patients. Performs overall utilization management, resource management, discharge planning and post-acute care referrals… more
    UPMC (04/17/25)
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  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …well-being of the unique communities we serve. **Summary:** This position facilitates utilization management processes to support the right care is provided at the ... right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care,… more
    UNC Health Care (04/03/25)
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  • Utilization Management Denial Review

    UCLA Health (Los Angeles, CA)
    …leader with: + Current CA LVN licensure required + Two or more years of utilization review / utilization management experience in an HMO, MSO, IPA, or health ... UCLA Health. You will play a key part in promoting high-quality, cost-effective medical care by applying clinical acumen and applicable policies and guidelines in… more
    UCLA Health (03/27/25)
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