• Utilization Review Registered

    MaineGeneral Health (Augusta, ME)
    Job Summary: MaineGeneral Health is offering an exciting opportunity for an experienced Utilization Review Registered Nurse (RN) to join our team. If you ... we want to hear from you! Job Description: The Utilization Review Team at MaineGeneral prides itself...will have: + State of Maine licensure as a Registered Nurse (RN) or ability to obtain… more
    MaineGeneral Health (06/26/25)
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  • RN Utilization Review

    Ascension Health (Jacksonville, FL)
    …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 (06/18/25)
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  • Utilization Review Registered

    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
    Emory Healthcare/Emory University (06/21/25)
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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 (06/24/25)
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  • Utilization Review

    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
    Community Health Systems (04/25/25)
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  • Registered Nurse Utilization

    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
    LifePoint Health (05/15/25)
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  • Nurse

    Veterans Affairs, Veterans Health Administration (San Francisco, CA)
    …and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a ... Summary The Revenue Utilization Review (RUR) nurse ...processes and under moderate supervision and instruction by the registered nurse manager. Responsibilities of the RUR… more
    Veterans Affairs, Veterans Health Administration (06/24/25)
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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 (06/18/25)
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  • RN Registered Nurse

    Ascension Health (Tulsa, OK)
    **Details** + **Department:** Utilization Review + **Schedule:** FT, Monday-Friday, 8am-430pm + **Hospital:** Ascension St. John's Medical Center + **Location:** ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (06/14/25)
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  • Registered Nurse

    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
    Ascension Health (05/17/25)
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  • Registered Nurse (RN) Case Manager…

    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
    Ochsner Health (04/30/25)
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  • Registered Nurse

    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
    Beth Israel Lahey Health (05/17/25)
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  • Utilization Review Nurse

    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 ... management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure --...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (06/06/25)
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  • Utilization Review Nurse

    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
    US Tech Solutions (04/18/25)
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  • Case Manager Utilization Review

    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
    Beth Israel Lahey Health (05/11/25)
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  • Clinical Review Nurse - Prior…

    Actalent (Columbus, OH)
    Utilization management + Prior authorization + Utilization review + Clinical review + Patient care + Licensed registered nurse Additional Skills & ... healthcare providers and the authorization team to ensure timely review and approval of services. Responsibilities + Perform medical...Nurse - State Licensure required OR RN - Registered Nurse - State Licensure and/or Compact… more
    Actalent (06/19/25)
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  • Utilization Review Nurse

    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
    The County of Los Angeles (05/22/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
    …of care. Follows procedures per established policies and guidelines. Responsibilities The Utilization Management (UM) Registered Nurse (RN) executes position ... leadership, experience, and creative approaches to management of complex utilization processes. Practical experience in the application of UM...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (06/18/25)
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  • Registered Nurse

    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, ... identification of types ofhealthcare services for which preauthorization or concurrent review will be required.Reviews previous and present medical care practices as… more
    ERP International (06/18/25)
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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 (03/30/25)
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