- The County of Los Angeles (Los Angeles, CA)
- …or squatting. Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...? In the County of Los Angeles, a Utilization Review Nurse is an RN … 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...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review ...as needed with prior notice. MUST HAVE + Active RN License Required - TX or Compact License. + 2-4 ... case management, and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to assess the member's overall health,… more
- Medical Mutual of Ohio (OH)
- …Ohio State Nursing Board. Bachelor's degree preferred. + 3 years experience as a Registered Nurse in acute care, critical care, emergency medical or medical ... medical coding or medical documentation investigation preferred. **Professional Certification(s):** + Registered Nurse with current State of Ohio unrestricted… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review (West Coast) Job Description We are seeking a dedicated Clinical Review Nurse to perform ... and appropriate setting. + Prepare denial letters for concurrent review without member or provider outreach. + Work within...as Excel, Outlook, Word, and OneNote. Essential Skills + RN License required for the state of residence; Compact… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... the TRICARE beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary prior authorization requests for medical… more
- Children's Mercy Kansas City (Kansas City, MO)
- …EMR and use software program are all preferred. + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire ... beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise,...+ One of the following: Licensed RN - Kansas, Registered Nurse … more
- Elevance Health (Louisville, KY)
- **Clinical Review Nurse I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Medicaid Services to transform federal health programs. The **Clinical Review Nurse ** is responsible for reviewing and...which would provide an equivalent background. + Current unrestricted RN license required. + **This position is part of… more
- Houston Methodist (Houston, TX)
- …Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for promoting the achievement of optimal ... expert level at all objectives delineated in the Utilization Review Nurse and Utilization Review ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- CDPHP (Latham, NY)
- …on nationally recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York State license required. ... to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the...years of acute care experience is required as a Registered Nurse . + Minimum of two (2)… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review * **Location:** *MN-Minneapolis-Downtown Campus*… more
- Monroe County, NY (Rochester, NY)
- Full Jobs List Full Exams List Registered Nurse ( RN ) - Utilization Review Unit, Per Diem Location: Rochester, NY Title: Registered Nurse ( RN ) ... Description of Duties This position is in the Utilization Review Unit and functions as an assessment nurse...Qualifications Possession of a New York State License as a Registered Nurse . Download/View Full Announcement Apply… more
- US Tech Solutions (Chicago, IL)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... months of Prior Authorization. **Education:** + Active and unrestricted RN licensure in state of residence **Questionnaire:** + Do... Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Molina Healthcare (Warren, MI)
- …hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- UNC Health Care (Kinston, NC)
- …EXPERIENCE REQUIREMENT** + Five (5) years of health care experience as a Registered Nurse . **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a ... patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of...Registered Nurse in the state of North Carolina. **KNOWLEDGE, SKILLS… more
- Centene Corporation (Olympia, WA)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure required Pay Range: ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- AdventHealth (Orlando, FL)
- …of experience in home health + 2 years of experience in management position. + Registered Nurse State Licensure and/or Compact State Licensure + Cert for Oasis ... **Population Health Case Manager ( RN ) AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Benefits from Day One + Paid Days… more
- Centene Corporation (Sacramento, CA)
- …a fresh perspective on workplace flexibility. Remote position. Must work PST ** RN -Must hold a current CA license.** **Must have** **5-7 years related** **experience ... in UM-Concurrent Review . 2+ years of acute care experience required. 10%...management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + For Health Net… more
- US Tech Solutions (May, OK)
- …experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... clinical policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. . Reviews… more