• Sprenger Wellspring Silver Maple (Lorain, OH)
    …professional nurse in conjunction with other members of the health care team ( physician , therapists, nurses, medical social worker, and home health aide) based on ... and Supplies Intervention Performs skilled nursing procedures as ordered by patients physician in accordance with Home Health policies and procedures and LPN… more
    Upward (07/31/25)
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  • Aveanna Healthcare (Birmingham, AL)
    …the plan of care and patient needs. Participates in quality improvement, utilization review , and infection control activities as requested. Attends appropriate ... as established by the plan of care, the interdisciplinary team, attending physician and Hospice Medical Director. Territory is primarily Jefferson County, AL.… more
    Upward (08/12/25)
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  • GIBSON AREA HOSPITAL (Gibson City, IL)
    …or individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define the structure, ... and fluid intake at lunch as ordered by the physician to ensure adequate calorie intake and to prevent...levels through use of data sources and compliance peer review monitoring. 47. Cooperates and collaborates with co-workers to… more
    Upward (07/31/25)
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  • Knox Community Hospital (Mount Vernon, OH)
    …with HIPAA regulations. Communication with nursing units concerning laboratory service issues. Review and secure a complete physician order for all laboratory ... a willingness to perform cross functional duties to insure optimal utilization of departmental resources. Attends and participates in departmental staff meetings.… more
    Upward (08/05/25)
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  • US Fish and Wildlife Service (Titusville, FL)
    …and instruct lower graded employees on crewmember duties; 2) plan action and direct utilization of fireline resources on less complex fires; and 3) for more complex ... must be determined physically fit by an authorized government physician to perform strenuous and physically demanding duties; and...Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the… more
    Upward (08/09/25)
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  • GIBSON AREA HOSPITAL (Gibson City, IL)
    …and patient education or assist with diagnostics, such as specialized tests per physician orders. GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENT To provide ... or individualizes a predefined, goal consistent and continuous manner by utilization of and adherence to pre-determined standards which define the structure,… more
    Upward (07/31/25)
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  • WORKCARE INC (Albany, OR)
    …company policies/procedures. Coordinates care with other WorkCare programs, using physician escalation services, as needed. Provides evidence-based practices and ... practice and as supported by the CMD or Medical Review Officer (MRO). Assists the CMD with health care...to incident reports and tracking of injury and clinic utilization data. Actively participates in emergency response team activities,… more
    Upward (07/31/25)
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  • Utilization Review Physician

    Hackensack Meridian Health (Hackensack, NJ)
    The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Hackensack University Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
    Hackensack Meridian Health (07/01/25)
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  • RN Utilization Review

    Sedgwick (Dayton, OH)
    …provider's office. + Utilizes evidence-based criteria and jurisdictional guidelines to form utilization review determinations. + Pursues Physician Advisor ... Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review **PRIMARY PURPOSE** : To provide timely, evidence-based utilization more
    Sedgwick (09/16/25)
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  • Registered Nurse - Utilization

    Beth Israel Lahey Health (Boston, MA)
    …a difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining ... the level of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure… more
    Beth Israel Lahey Health (09/10/25)
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  • System VP Utilization Management

    CommonSpirit Health (Phoenix, AZ)
    …by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification ... This role will be an expert on matters regarding physician practice patterns, over and under- utilization of...by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. **Required… more
    CommonSpirit Health (09/05/25)
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  • Medical Director - Behavioral Health, Aetna…

    CVS Health (Oklahoma City, OK)
    …psychiatrist. * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. * Child/Adolescent Board ... Medical Director (Behavioral Health), you will: * Provide leadership and day-to-day physician oversight for utilization management team, including the management… more
    CVS Health (08/27/25)
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  • Physician Advisor - UM MSQ

    BayCare Health System (Riverview, FL)
    …certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) + Preferred - Physician Advisor Sub-Specialty ... the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. + Develops expertise… more
    BayCare Health System (08/29/25)
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  • Physician Advisor

    Hackensack Meridian Health (Brick, NJ)
    …Engage in the teaching, consulting and advising of the care management and utilization review departments and hospital leadership. + Collaborate with a ... . + Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is **preferred** . + Physician more
    Hackensack Meridian Health (09/14/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician more
    The County of Los Angeles (06/28/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
    Commonwealth Care Alliance (09/05/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which...actions to UR Committees, as appropriate * Partners with Physician Advisor to engage in second level review more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • Utilization Review Nurse Coordinator

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    Utilization Review Nurse Coordinator Office/On-site Recruitment # 250910-5613FP-001 Location East Hartford, CT Date Opened 9/15/2025 12:00:00 AM Salary $86,261 - ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=)… more
    State of Connecticut, Department of Administrative Services (09/16/25)
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  • Utilization Review Specialist

    Emory Healthcare/Emory University (Atlanta, GA)
    …mentorship, _development,_ and leadership programs + And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible ... of recent acute hospital experience or a minimum of two years of previous utilization review experience. + Must have a valid, active unencumbered Registered… more
    Emory Healthcare/Emory University (09/13/25)
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