- 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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Albany Medical Center (Albany, NY)
- Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Utilization Review Nurse Salary Range: $31.28 - $51.61 per hour ... for assigned patients. Qualifications and Ideal Characteristics + Registered nurse with a New York State current license. +...Basic knowledge of computer systems with skills applicable to utilization review process. + Excellent written and… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... in this remote position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and continued stay reviews… more
- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria more
- Glens Falls Hospital (Glens Falls, NY)
- …be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On Bonus for ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... for acute and subacute rehabilitation, transportation and DME requests. Review of identified high-cost admissions and extended stays and...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in ... will be required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties… more
- Beth Israel Lahey Health (Burlington, MA)
- …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
- University of Utah Health (Salt Lake City, UT)
- …and 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, or obtain one...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- The Cigna Group (Bloomfield, CT)
- … LVN. Compact license a plus *Minimum 2-3 years clinical experience. * Utilization Review or Utilization Management experience *Experience in regulated ... *Responsible for the effective and sufficient support of all Utilization Management activities to include review of...of all Utilization Management activities to include review of inpatient and outpatient medical services for medical… more
- Universal Health Services (Temecula, CA)
- …Healthcare Regional office in Temecula, CA is seeking Two (2) LVN Full-Time Central Utilization Review Nurses who will be responsible for carrying out ... correct payer source for hospitalization and communication. + Ensures compliance of utilization review practices as required by payers, external regulatory… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... Work Work Shift: Day (United States of America) Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. Salary… more
- Actalent (Kansas City, MO)
- …managed care organization on a Sunday to Thursday OR Tuesday to Saturday basis doing utilization review for PAC patients. This role is looking for a May 20th ... + MINIMUM 2 years clinical experience in a clinical setting + Experienced in Utilization Management and knowledge of URAC & NCQA standards + Broad knowledge of… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Beth Israel Lahey Health (Burlington, MA)
- …40 **Work Shift:** Day (United States of America) Joint role of Case Manager and Utilization Review Nurse Hospital at Home Full Time Days 8:00am-4:30pm ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
- Dartmouth Health (Lebanon, NH)
- Overview 40 hours per week - Fully Remote Position The Utilization Review RN facilitates transitions of care and bed availability through review of patient ... These are just a few highlights of being a nurse at Dartmouth Hitchcock Medical Center and Clinics in...and computer skills desired. Required Licensure/Certifications - Licensed Registered Nurse with NH eligibility - Basic Life Support (BLS)… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... + Bachelor's Degree: Nursing + Associate's Degree: Nursing + Three years: Utilization Review , Care Management, Quality Management, and/or Discharge planning… more
- UCLA Health (Los Angeles, CA)
- …leader with: * Current CA LVN licensure required * Two or more years of utilization review / utilization management experience in an HMO, MSO, IPA, or health ... and guidelines in the issuance of adverse organization determinations. You will review for appropriate care and setting while working closely with denial… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …communication with clinic, payor and other customers. **Job Title: Licensed Vocational Nurse Utilization Review -** ** Utilization Management** **Location: ... **Responsibilities** The Utilization Review LVN nurse will perform documentation review for medical necessity and benefit correlation of requested… more