• Utilization Review Nurse

    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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… 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 ... provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team of talented… 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 ... 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria more
    Milford Regional Medical Center (04/29/25)
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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 ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (04/07/25)
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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 ... will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties… more
    The Arora Group (02/20/25)
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  • Utilization Review Nurse

    Beth Israel Lahey Health (Burlington, MA)
    …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
    Beth Israel Lahey Health (02/14/25)
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  • Utilization Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... review programs and key performance indicators for all utilization review activities. + Interact with medical,...staff **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer… more
    Ascension Health (03/26/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
    US Tech Solutions (04/18/25)
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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 ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
    Albany Medical Center (04/25/25)
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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 ... of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for creating positive patient interactions is valued?… more
    HCA Healthcare (04/25/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ..... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
    US Tech Solutions (04/18/25)
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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 based on… 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 Review

    AmeriHealth Caritas (Dover, DE)
    …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... preferred. + An active OH or compact state Registered Nurse (RN) license in good standing is required. +...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
    AmeriHealth Caritas (04/29/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
    Beth Israel Lahey Health (04/16/25)
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  • Utilization Review Registered…

    BJC HealthCare (St. Louis, MO)
    … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization more
    BJC HealthCare (04/23/25)
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  • Registered Nurse (RN) - Utilization

    LifePoint Health (Las Cruces, NM)
    …harassment in employment." **Job:** **Nursing* **Organization:** **Memorial Medical Center* **Title:** *Registered Nurse (RN) - Utilization Review - Full ... you're not just valued as an employee, but as a person. As a registered nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities… more
    LifePoint Health (04/28/25)
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  • RN- Utilization Review Weekender…

    Baptist Memorial (Meridian, MS)
    …Job Description Title: RN Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity ... and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance… more
    Baptist Memorial (04/22/25)
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  • RN, Utilization Review Flexi

    Chesapeake Regional Healthcare (Chesapeake, VA)
    * Remote in Hampton Roads* Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and applies ... as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical… more
    Chesapeake Regional Healthcare (02/16/25)
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