• Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …_development,_ and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible ... for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review more
    Emory Healthcare/Emory University (07/19/25)
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  • Utilization Review Nurse

    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
    The County of Los Angeles (06/28/25)
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  • Utilization Review Specialist…

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... this position is able to cover a multitude of utilization review functions through point of entry,...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/29/25)
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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 (06/27/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
    Beth Israel Lahey Health (05/11/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening ... **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (07/29/25)
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  • RN Utilization Review Full…

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review Full Time Days - 2506001796 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...Conditions of Participation and Tenet policies Operates within the RN scope of practice as defined by state licensing… more
    Tenet Healthcare (07/31/25)
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  • Utilization Review Nurse

    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 ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/25/25)
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  • Utilization Review Nurse

    Dignity Health (Carmichael, CA)
    **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN ** is ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...with physicians, payers, Care Coordinators and other stakeholders regarding review outcomes. + Collaborates with facility RN more
    Dignity Health (07/25/25)
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  • RN - Utilization Review

    Baptist Memorial (Meridian, MS)
    Overview RN Utilization Review Weekender Job...Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible for ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...experience Preferred/Desired: RN with Case Management or Utilization Review experience in a hospital or… more
    Baptist Memorial (07/21/25)
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  • Utilization Review RN Point…

    Trinity Health (Des Moines, IA)
    …Iowa (IA), MercyOne Des Moines Join the MercyOne Family! We are looking to hire a Utilization Review RN ! Responsible for the review of inpatient and ... discharge. + Carries out hospital programs and principles of utilization review in compliance with hospital policies...SKILLS AND ABILITIES REQUIRED:** + Current licensure as a registered nurse in the State of Iowa.… more
    Trinity Health (07/30/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
    Beth Israel Lahey Health (07/29/25)
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  • Utilization Review Clinician…

    Centene Corporation (San Antonio, TX)
    …Counselor required or + LMFT - Licensed Marital and Family Therapist required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... the Texas BHEC as an LPC, LCSW, or LMFT. Registered Nurse must have direct psychiatric/mental health...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
    Centene Corporation (07/31/25)
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  • RN - Utilization Review

    Baptist Memorial (Memphis, TN)
    Overview Purpose of Position and Scope of Responsibility 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...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
    Baptist Memorial (06/14/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Omaha, NE)
    Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive ... of a Commonspirit Health Facility Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and… more
    Catholic Health Initiatives (06/21/25)
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  • Utilization Review Intake RN

    AdventHealth (Glendale Heights, IL)
    …60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...capacity to prioritize multiple tasks and role components. + Registered Nurse ( RN ) Required +… more
    AdventHealth (06/13/25)
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  • Utilization Review Case Manager

    Covenant Health (Nashua, NH)
    …health care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices. + ... + Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all...to work remotely as needed Education and Experience + Registered Nurse licensed in New Hampshire required… more
    Covenant Health (07/30/25)
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  • RN Registered Nurse

    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
    Ascension Health (07/26/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...a related field required; advanced degree or licensure (eg, RN , LCSW, LPC, LMHC, or CADC) preferred. + Excellent… more
    BriteLife Recovery (07/03/25)
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