- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …programs + And more **Description** The ** Utilization Review (UR) Specialist ** is a Registered Nurse responsible for conducting thorough medical ... experience or a minimum of two years of previous utilization review experience. + Must have a... experience. + Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
- 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 receiving substance use disorder (SUD)… more
- HonorHealth (AZ)
- …different here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- HonorHealth (AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... Registered Nurse in an acute care setting - RequiredLicenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure - Required… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for ... Utilization Review Nurse and Utilization Review Specialist Nurse...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Penn State Health (Hershey, PA)
- …information._ **Union:** SEIU Healthcare Pennsylvania **Position** RN Registered Nurse Utilization Management Specialist - Utilization Management ... setting required. + Currently licensed to practice as a Registered Nurse by state of employment or... by state of employment or holds a multistate RN license through the interstate Nurse Licensure… more
- Children's Mercy Kansas City (Kansas City, MO)
- …Oversees and directs the work of Nurse Case Managers, Social Workers, and Utilization Review specialist team members and support staff + Analyzes, ... and related software applications and implementations. + Engages in utilization review committee. Qualifications + Master's Degree...Performance Improvement Leadership + One of the following: Licensed RN - MO, Registered Nurse … more
- St. Luke's University Health Network (Allentown, PA)
- …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for...experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse ( RN ) - Case...and continuity of care to prevent readmission. 35% C. Utilization Review : 1. Performs utilization ... Years in an acute care setting, case management or utilization review Req 1 Year of acute...acute case management/discharge planning experience Pref Licenses and Certifications RN - Registered Nurse Upon… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- Summary The Albany VAMC is looking to fill (1) Registered Nurse - ACCREDITATION QUALITY SPECIALIST This job announcement is open only for current, full time, ... pass a physical with driving requirements for this position. Responsibilities The Registered Nurse Accreditation Quality Specialist executes leadership that… more
- MyFlorida (Pensacola, FL)
- REGISTERED NURSE SPECIALIST - 64084653 Date: Sep 10, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Requisition No: 859739 Agency: Department of Health Working Title: REGISTERED NURSE SPECIALIST - 64084653...Reports. Participates in mandatory monthly Fetal and Infant Mortality Review (FIMR) meetings. Participates in in services and staff… more
- Roper St. Francis (Charleston, SC)
- …Charge Nurse I. Experience: Experience: At least 2 years� experience as a registered nurse in a direct care patient setting for Primary Charge Nurse ... role. Licensure/Certification: Applicant must be currently licensed as a Registered Nurse in South Carolina or hold...to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and… more
- Cedars-Sinai (Los Angeles, CA)
- …Los Angeles Fair Chance Initiative for Hiring. **Req ID** : 10457 **Working Title** : Registered Nurse - Clinical Documentation Specialist - 8 Hour Days ... care field preferred Foreign trained MDs will be considered License/Certifications: Registered Nurse , LVN, Occupational Therapist, Physical Therapist, Physician… more
- Beth Israel Lahey Health (Cambridge, MA)
- …to the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by ... on the key performance indicators and quality measures, the RN specialist also aims to foster a...reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review … more
- Montrose Memorial Hospital (Montrose, CO)
- …provided. This position combines the unique skill sets of the Utilization Review Nurse and Clinical Documentation Specialist to facilitate documentation ... Revenue Cycle Initiatives. All About You : + Current Registered Nurse licensure in the state of...experience preferred; and one (1) to two (2) years Utilization Review experience preferred. What We Offer:… more
- MyFlorida (Land O' Lakes, FL)
- …that all verbal orders, including telephone orders from attending physicians are received by a registered nurse . If no RN is available, receive all telephone ... SENIOR REGISTERED NURSE SUPV - 50000070 Date:...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse ...that the residents are receiving total nursing care. + Review shift assignments and ensure that the assignments reflect… more
- MyFlorida (Port Saint Lucie, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... SENIOR REGISTERED NURSE SUPV Date: Aug 31,...resident's status and providing supervision and guidance to the RN , LPN, CNA, and other Allied Health Care Professionals.… more
- MyFlorida (Daytona Beach, FL)
- …that all verbal orders, including telephone orders from attending physicians, are received by a registered nurse . + If no RN is available, receive all ... SENIOR REGISTERED NURSE SUPV Date: Sep 9,...current status and providing supervision and guidance to the RN , LPN, CNA and other Allied Health Care Professionals.… more