• Group Director Utilization Review

    Tenet Healthcare (Detroit, MI)
    …care options May, if licensed RN , oversee work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator. (10% daily, essential) Compliance ... Group Director Utilization Review - 2506000536 Description :...(CPA) preferred, Six Sigma Green Belt preferred · Valid Registered Nurse ( RN ) preferred PHYSICAL… more
    Tenet Healthcare (04/20/25)
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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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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Buffalo, NY)
    … experience in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a license and ... nursing experience, one of which must have included utilization review and/or discharge planningORCandidates within State Service can be considered… more
    New York State Civil Service (05/01/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Bronx, NY)
    … experience in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a license and ... to individual diagnosed with mental illness. Candidates from outside or within State Service can apply.As a Utilization Review Coordinator, your duties… more
    New York State Civil Service (04/05/25)
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  • Licensed Practical Nurse (LPN)…

    The Arora Group (Bethesda, MD)
    …+ The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. + The ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently...not exceed 80 hours within a 2-week pay period. Services will be required on Federal holidays. DUTIES OF… more
    The Arora Group (02/20/25)
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  • Utilization Review Nurse

    Beth Israel Lahey Health (Burlington, MA)
    …a difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts +… more
    Beth Israel Lahey Health (02/14/25)
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  • Utilization Review Nurse

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse ( RN ) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse ( RN...our team of talented professionals who provide health care services to our Military Service Members and… more
    Matrix Providers (04/29/25)
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  • Case Manager Utilization Review

    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 ... Weekend and holiday rotations required **Job Description:** The Inpatient Registered Nurse ( RN ) Case Manager...Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review more
    Beth Israel Lahey Health (04/16/25)
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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 + Services As ... **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 (05/06/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (05/03/25)
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  • RN - Utilization Review

    Baptist Memorial (Meridian, MS)
    Overview RN Utilization Review Weekender Job...healthcare services and treatment as prescribed by utilization review standards. The UR Nurse ... 22818 FLSA Status Job Family: NURSING Job Description Title: RN Utilization Review Weekender Job...Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible… more
    Baptist Memorial (04/22/25)
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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 (04/19/25)
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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 ... 250,000 residents in Plymouth and Barnstable counties. Our Nutrition Services Team consists of registered and licensed...and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you… more
    Beth Israel Lahey Health (04/29/25)
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  • Utilization Review Clinician…

    Centene Corporation (San Antonio, TX)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... BHEC if you hold a LPC, LCSW, or LMFT. Registered Nurse can hold Texas State Licensure...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
    Centene Corporation (05/10/25)
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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 ... **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize… more
    Catholic Health Initiatives (04/23/25)
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  • Utilization Review Nurse

    Adecco US, Inc. (Houston, TX)
    Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This role is in person / on site. Please read below ... 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . **...to assess the necessity and appropriateness of treatments and services . . **Conduct Audits:** Regularly audit medical records and… more
    Adecco US, Inc. (05/01/25)
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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...clinical reviews and documentation. + Communicate clinical necessity of services based on ASAM criteria and DSM-5 diagnoses. +… more
    BriteLife Recovery (04/30/25)
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  • Registered Nurse Care Manager…

    Catholic Health (Buffalo, NY)
    …Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse ( RN ) Care Manager- Utilization Review , as an active member of the Care Management ... and interdisciplinary care team, provides comprehensive Utilization Review and discharge services ...BS Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York… more
    Catholic Health (05/01/25)
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  • RN Registered Nurse

    Ascension Health (Tulsa, OK)
    …OR Required professional licensure at time of hire. **Additional Preferences** + 5+ years RN experience + Utilization Review experience preferred **Why Join ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (05/06/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
    Albany Medical Center (04/25/25)
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