- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound ... a valid job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg*… more
- 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 ... $167,136.48 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5125L Department HEALTH SERVICES Opening...information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors 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 ... $177,314.88 Annually Location Los Angeles County, CA Job Type Full time Job Number Y5126D Department HEALTH SERVICES Opening...and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General… more
- Elevance Health (Morgantown, WV)
- RN Utilization Management/ Review Nurse - InPatient Medicaid (JR155056) **Location:** This position requires you to **reside in the state of West Virginia.** ... **Virtual:** This role enables associates to work virtually full -time providing maximum flexibility and autonomy. This approach promotes...Monday through Friday, 8am - 5pm The **Medical Management Nurse ** (Medicaid Utilization Review ) is… more
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... Bachelor's Degree in Nursing (BSN) preferred. + A Registered Nurse (RN) license in the District of Columbia in...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
- Ascension Health (Wichita, KS)
- **Details** + **Department:** Utilization Review + **Schedule:** Full time, 36 hrs, Day shift, 7:30 AM- 4:00 PM, Monday-Friday, rotating weekends possible + ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more
- 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
- AmeriHealth Caritas (Philadelphia, PA)
- …the case is presented to the Medical Director for medical necessity review . Upon approval of services, responsibilities include timely notification and education to ... longer needed or until the member's 21st birthday. ;The nurse will maintain current knowledge and understanding of the...a clinical setting. + Minimum of 3 years of Utilization Management experience, preferably within a managed care organization.… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …care. Follows procedures per established policies and guidelines. Responsibilities The Utilization Management (UM) Registered Nurse (RN) executes position ... demonstrate leadership, experience, and creative approaches to management of complex utilization processes. Practical experience in the application of UM methods and… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a ** Utilization Management Registered Nurse (RN)** for a full -time position supporting the 2d Medical Group, ... Six years of clinical nursing experience is required. One year of experience in Utilization Management is required. Full time employment in a nursingfield within… 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: ... Full Time Requisition ID: 12249 Salary Range: $88,854.00 (Min.)...net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,… 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 and use of...in NUMI following VACO UM process and then InterQual review process. Facilitates and coordinates admissions to the most… more
- New York State Civil Service (Albany, NY)
- …of post-licensure clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's degree in nursing ... HELP No Agency Corrections and Community Supervision, Department of Title Registered Nurse 3 - Utilization Temp/Hourly Occupational Category Health Care,… more
- Katmai (Fort Carson, CO)
- …experience in Utilization Management. + Must possess a current, active, full , and unrestricted Registered Nurses (RN) licensed in Colorado, be able to practice ... need for inpatient/outpatient precertification. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to the...using a nurse compact state license or have a license from… more
- 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 ... **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of...Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review ...+ Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + ... + Req #:41904-31044 + FTE:1 + Posted:May 15, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
- Beth Israel Lahey Health (Plymouth, MA)
- **Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of America) **FLSA Status:** Non-Exempt **When you join the growing BILH team, ... taking a job, you're making a difference in people's lives.** full time **Job Description:** Beth Israel Deaconess Hospital-Plymouth recognizes Integrity, Respect,… more
- 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
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/210205/registered- nurse -case-manager utilization ... effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more