- Emory Healthcare/Emory University (Atlanta, GA)
- …+ Ongoing mentorship and leadership programs + And more! **Description** The **Registry Utilization Review Nurse ** (PRN) is responsible for conducting ... attending physician and/or physician advisor. + The UR RN (PRN) will perform utilization review by completing a timely and comprehensive review of all new… more
- 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
- Community Health Systems (Naples, FL)
- …written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure Current ... **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
- LifePoint Health (Louisburg, NC)
- …**Please select a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review Coordinator* **Location:** ... Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound… more
- HCA Healthcare (Nashville, TN)
- …of nursing experience required + 1-4 years of relevant case management/ utilization review experience preferred + Registered Nurse - Currently licensed as ... **Introduction** Do you have the career opportunities as a(an) Utilization Review Services RN you want with...a registered professional nurse in the state in which he or she… more
- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Ascension Health (Baltimore, MD)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Ochsner Health (New Orleans, LA)
- …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the… more
- Ascension Health (Pensacola, FL)
- **Details** **Department: Utilization Review ** **Schedule: M-F 0800-1630 with rotating Holidays** **Hospital: Ascension Sacred Heart Pensacola** **Location: ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… 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 ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- US Tech Solutions (Chicago, IL)
- …you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About ... + 3+ years of experience as an RN + Registered Nurse in state of residence +...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Beth Israel Lahey Health (Burlington, MA)
- …people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse (RN) Case Manager for ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print...-OR- OPTION II: Two (2) years of experience as a registered nurse , of which one year must be ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 -...+ A current, active license to practice as a Registered Nurse issued by the California Board… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for UM reviews for patients who receive hospital care. Responsibilities An UM ... Registered Nurse is responsible for UM reviews...in NUMI following VACO UM process and then InterQual review process. Facilitates and coordinates admissions to the most… 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 ... Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP), Certified Informatics Nursing,...full, active, and unrestricted license to practice as a Registered Nurse as required in the TO… more
- AdventHealth (Orlando, FL)
- …water, creating a holistic environment. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...and valid license to practice in Florida as a Registered Nurse (ADN or BSN) required. +… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with ... and can retrieve information from multiple sources/packages for case review (ie, CPRS, VistA, Outlook, NUMI, etc.) The responsibilities...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
- New York State Civil Service (Sonyea, NY)
- NY HELP No Agency Corrections and Community Supervision, Department of Title Registered Nurse 3 ( Utilization ) Occupational Category Health Care, ... Possession of a license and current registration as a registered professional nurse in New York State;...clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's… more