- 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...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Milford Regional Medical Center (Milford, MA)
- …our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization management at MRMC. The UR ... of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria more
- R1 RCM (Pittsburgh, PA)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Utilization Review Nurse ** , you will help our hospital clients by ... position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and continued stay reviews utilizing InterQual… more
- Glens Falls Hospital (Glens Falls, NY)
- …hours per week, can be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On ... Fulfill Your Potential* *Responsibilities* * Conducts concurrent and retrospective review (s) utilizing InterQual (IQ) medical necessity criteria to monitor… more
- Albany Medical Center (Albany, NY)
- …Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour Responsible ... Delay Management for assigned patients. Qualifications and Ideal Characteristics + Registered nurse with a New York State current license. + Bachelor's degree… more
- InnovaCare (San Juan, PR)
- …to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization ... visits to Acute, SNF, and Rehabilitation Inpatient facilities to concurrently review admissions and continued stay to determine appropriate Utilization, Quality… more
- Actalent (Tampa, FL)
- Actalent is hiring a Clinical Review Nurse for a fully remote role! In this role you are primarily responsible for Utilization Review and Concurrent ... Review of post-acute care. Requirements Must have compact RN license 5 years of nursing experience (1-2 years of acute nursing required) Telephonic case management/triage experience Schedule Sunday-Thursday 9am-6pm EST About Actalent Actalent is a global… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... reviews for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and inpatient… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding ... year clinical experience required. + A minimum of two (2) years quality/utilization review experience in an HMO, managed care organization, or similar experience as… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate,...THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties in… more
- University of Utah Health (Salt Lake City, UT)
- …appropriateness of admissions with associated levels of care and continued stay review . + Communication to third-party payers for initial and concurrent clinical ... review . + Reviews patient chart to ensure patient continues...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- Beth Israel Lahey Health (Burlington, MA)
- …is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three payments. You ... **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based… more
- Centene Corporation (New York, NY)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... care to members + Provides feedback on opportunities to improve the authorization review process for members + Performs other duties as assigned + Complies with… more
- Humana (Columbus, OH)
- …first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
- Humana (Dublin, OH)
- …put health first** Humana Healthy Horizons is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
- Centene Corporation (Sacramento, CA)
- …teams on projects within utilization management as part of the clinical review team + Partners and works with Medical Affairs and/or Medical Directors ... diagnoses, prognoses, resources, and/or preferences + Manages and maintains concurrent review findings, discharge plans, and actions taken on member medical records… more
- Centene Corporation (Helena, MT)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more
- Centene Corporation (Tallahassee, FL)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... care to members + Provides feedback on opportunities to improve the authorization review process for members + Performs other duties as assigned + Complies with… more
- Universal Health Services (Temecula, CA)
- …office in Temecula, CA is seeking Two (2) LVN Full-Time Central Utilization Review Nurses who will be responsible for carrying out utilization management functions ... source for hospitalization and communication. + Ensures compliance of utilization review practices as required by payers, external regulatory agencies, and… more
- Albany Medical Center (Albany, NY)
- …findings based on Departmental standards. * While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate ... * Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies. * Facilitates removal of delays and… more
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