- Nuvance Health (Danbury, CT)
- *Description* Summary: Required- Registered Nurse ( RN) The purpose of the Utilization Management Nurse is to support the physician, the ... other duties as required. Education: ASSOCIATE'S LVL DGRE Preferred- Two Years Utilization Review Experience Required- Registered Nurse ( RN) Working Conditions:… 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, ... Services will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW: + Initiate, perform and complete assigned… more
- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our.... Overview: Serve as a key member of the Utilization Management team, providing comprehensive support to… 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 ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
- Beth Israel Lahey Health (Burlington, MA)
- …in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based ... based on medical necessity and documentation is sufficient to support the level of care being billed. Conducts concurrent...billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to… more
- Humana (Bismarck, ND)
- …community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Adecco US, Inc. (Houston, TX)
- Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This role is in person / on site. Please read below and ... 8am to 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . **Review Medical Records:** Thoroughly evaluate patient… more
- Humana (Tallahassee, FL)
- …Humana Healthy Horizons in Florida is seeking a Utilization Management Nurse who utilizes clinical nursing skills to support the coordination, documentation ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 's work assignments are varied and frequently… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in providing ... Bachelor's degree in nursing + Certifications in addition to Basic Life Support : Certified/certification eligible in relevant specialty, such as Certified Managed… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose....net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... retrospective inpatient and outpatient services, in accordance with the utilization requirements and 3rd party payor contracts. The UM department is responsible for… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Hospital:** Ascension St. ... range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes and… more
- CDPHP (Albany, NY)
- …share 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 ... + Minimum two (2) years of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization Management experience is preferred. +… more
- US Tech Solutions (Chicago, IL)
- …Medicare). + Independently coordinates the clinical resolution with internal/external clinician support as required. + Processes and evaluates complex data and ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST… more
- AmeriHealth Caritas (Dover, DE)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon to: +...preferred. + An active OH or compact state Registered Nurse (RN) license in good standing is required. +… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Facility:** St. Agnes Hospital ... care services regarding admissions, case management, discharge planning and utilization review. Responsibilities: + Review admissions and service requests within… more
- US Tech Solutions (May, OK)
- …Medicare). . Independently coordinates the clinical resolution with internal/external clinician support as required. . Processes and evaluates complex data and ... . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior...in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT… more
- 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
- 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 have an ... Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny...Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for creating positive… more
- Katmai (Fort Carson, CO)
- …staff activities. + Establish effective rapport with other employees, professional support service staff, customers, clients, patients, families, and physicians. + ... Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,...licensed in Colorado, be able to practice using a nurse compact state license or have a license from… more