- The County of Los Angeles (Los Angeles, CA)
- …or squatting. Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...? In the County of Los Angeles, a Utilization Review Nurse is an RN … more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-Site Recruitment # 250715-5612FP-001 Location New Haven, CT Date Opened 7/22/2025 12:00:00 AM Salary $78,480 - ... View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to make a difference… 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 NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of care using...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Centene Corporation (Little Rock, AR)
- …+ LPN - Licensed Practical Nurse - State Licensure required. + RN - Registered Nurse Licensure, highly preferred **Working Shift:** M-F ... benefits including a fresh perspective on workplace flexibility. Clinical Review Nurse - Concurrent Review ...Commercial product in Arkansas (Not Medicaid & Medicare) + RN with experience in adult, pediatric, maternity, and behavioral… more
- Children's Mercy Kansas City (Kansas City, MO)
- …or demonstrated leadership skills in a previous role + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon ... beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise,...hire + One of the following: Licensed RN - Kansas, Registered Nurse … more
- CDPHP (Albany, NY)
- …on nationally recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York State license required. ... to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the...years of acute care experience is required as a Registered Nurse . + Minimum of two (2)… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review … more
- Dignity Health (Carmichael, CA)
- **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The **Utilization Review RN ** is responsible for ... with physicians, payers, Care Coordinators and other stakeholders regarding review outcomes. + Collaborates with facility RN ...regarding review outcomes. + Collaborates with facility RN Care Coordinators to ensure progression of care. +… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- Summary The New Mexico VA Health Care System is looking for a Registered Nurse - Peer Review - Quality & Patient Safety (QPS) Team! Responsibilities The ... Quality, Safety & Value (QSV) Peer Review Nurse Analyst completes and/or coordinates all...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …Responsibilities Duties include but not limited to: Utilization Review (UR) Registered Nurse ( RN ) is responsible for providing competent, evidence-based ... discharge/disposition planning for inpatient and outpatient settings. The UR RN assists Veterans, family members, and caregivers with receiving...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Staffing Solutions Organization (Augusta, ME)
- …diverse workforce, which is a reflection of our clients and the people they serve. ** Registered Nurse - Authorization Review Unit - MaineCare in Augusta, ... by the PA supervisor, utilizing PA software tools; + Review and authorize provider requests for the following services...Ability to develop and implement corrective actions. **Minimum Qualification:** Registered Nurse and three (3) years of… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse ( RN ) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound ... as an employee but as a person. As a registered nurse ( RN ) joining our...a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review Coordinator*… more
- Actalent (Sunrise, FL)
- Actalent is hiring a Utilization Management Nurse ! Job Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to ... in complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing continuity of care, ensuring smooth… 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 ... months of Prior Authorization. **Education:** + Active and unrestricted RN licensure in state of residence **Questionnaire:** + Do... Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Community Health Systems (Naples, FL)
- …meet deadlines. + Effective written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition… more
- UNC Health Care (Kinston, NC)
- …EXPERIENCE REQUIREMENT** + Five (5) years of health care experience as a Registered Nurse . **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a ... patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of...Registered Nurse in the state of North Carolina. **KNOWLEDGE, SKILLS… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure required Pay Range: ... with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive...processes preferred. NYS RN license required… more
- AmeriHealth Caritas (LA)
- …Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred. + An active Registered Nurse ( RN ) license in good standing is required. + 3+ ... When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines to… more
- AmeriHealth Caritas (Washington, DC)
- …environment. + Current driver's license required **Licensure:** + An active and unencumbered Registered Nurse license in the District of Columbia is required. ... When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines to… more
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