- Cleveland Clinic (Beachwood, OH)
- …the most respected healthcare organizations in the world. As Disability Plan Nurse , you will primarily review short-term disability request forms based ... This position requires 2 years of experience in Utilization Review , Quality or Care Management, Disability Plans,...Professional Nursing + Current state licensure as a Registered Nurse (RN) + Three years of clinical nursing experience… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate,...cover the cost of health insurance, long and short-term disability , and life insurance + Dental and vision plans… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Utilization Review Services Registered Nurse ? At Parallon, you come first. HCA Healthcare has ... you have the opportunity to make a difference. We are looking for a dedicated Utilization Review Services Registered Nurse like you to be a part of our team.… 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 NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- 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 and ... 8am to 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . ** Review Medical Records:** Thoroughly evaluate patient… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 123154 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL ... standards by adhering to Best Practices and participating in monthly peer review audits. + Ensure legal compliance by following regional, country and/or local… more
- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team...color, religion, sex, sexual orientation, gender identity, national origin, disability , or protected veteran status. For our EEO Policy… more
- Elevance Health (Chantilly, VA)
- RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - Thursday, ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the...bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance,… more
- Hackensack Meridian Health (Eatontown, NJ)
- …coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine that the coding ... in the system if inappropriate codes are identified. + Review each Hospice assessment to assure each CTI, 485...of the certified operation, Hospice Clinical Director, and the Nurse Manager for the appropriate operation. Demonstrates the ability… more
- Medical Mutual of Ohio (OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Clinical Appeal & Claim Review Nurse II_ **Location:** _Ohio_ **Requisition ID:** _2500127_ ... than 1.2 million members through our high-quality health, life, disability , dental, vision and indemnity plans. We offer fully...care. + Extrapolates and summarizes medical information for physician review or other external review . + Generates… more
- Ascension Health (Baltimore, MD)
- …plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance ... at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes and monitoring of… more
- US Tech Solutions (Chicago, IL)
- …experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff ... policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. +...3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior… more
- UNC Health Care (Kinston, NC)
- …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, ... movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as… more
- University of Utah Health (Salt Lake City, UT)
- …appropriateness of admissions with associated levels of care and continued stay review . + Communication to third-party payers for initial and concurrent clinical ... review . + Reviews patient chart to ensure patient continues...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- AmeriHealth Caritas (Dover, DE)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines to ... decisions. + Identify and escalate complex cases requiring physician review or additional intervention. + Ensure compliance with Medicaid...preferred. + An active OH or compact state Registered Nurse (RN) license in good standing is required. +… more
- Ascension Health (Baltimore, MD)
- …plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance ... care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and service requests within… more
- Community Health Systems (Naples, FL)
- **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 ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… more
- Ascension Health (Tulsa, OK)
- …plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance ... and salary range at the time of the offer._ **Responsibilities** + Review admissions and service requests within assigned unit for prospective, concurrent and… more
- US Tech Solutions (Columbia, SC)
- …promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and ... medical necessity guidelines. Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director,… more