- 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,...+ The Contractor shall perform pre-cert and authorization of insurance pertaining to patient admission and surgical admission as… 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
- 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, ... standards by adhering to Best Practices and participating in monthly peer review audits. + Ensure legal compliance by following regional, country and/or local… 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 ... **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . ** Review Medical...to facilitate approvals and organize necessary peer reviews. . ** Insurance Liaison:** Communicate with insurance companies to… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... review of relevant medical documentation, medical guidelines, and insurance benefits and communicates information to payers in accordance with contractual… 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 ... and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people,… 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...hour + Benefits: Competitive financial package with a comprehensive insurance package including health, dental, vision, and life coverage.… 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_ ... is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of...care. + Extrapolates and summarizes medical information for physician review or other external review . + Generates… 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...term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Ascension Health (Baltimore, MD)
- …- 139,681.30 per year **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term ... at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes and monitoring of… 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
- 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)
- …$115,939.20 per year **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and service requests within… more
- Ascension Health (Tulsa, OK)
- …+ **Location:** Tulsa, OK **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... and salary range at the time of the offer._ **Responsibilities** + Review admissions and service requests within assigned unit for prospective, concurrent and… more
- Calvert Memorial Hospital (Prince Frederick, MD)
- …surgical admission vs. observation status. Conducts daily clinical reviews for all insurance payers, facilitating medical peer to peer review requests. + ... required. + Experience : + Minimum 2 years in clinical nursing, utilization review , and/or case management. + Other Requirements : + Maintains unit-specific and… more
- Beth Israel Lahey Health (Plymouth, MA)
- …using Interqual criteria. + Integrates clinical knowledge with billing knowledge to review , evaluate, and appeal clinical denials related to the care provided to ... pleasant, professional and cooperative demeanor with patients, physicians, colleagues and insurance companies + Knowledge of government and insurance company… more
- Guthrie (Binghamton, NY)
- Up to a $15,000.00 Sign on Bonus! Summary: The Wellness Nurse plays a key role in health promotion and illness prevention of patient populations through ... nursing-patient collaboration and patient education. This nurse performs the Medicare Annual Wellness Visit under the direct supervision of a physician (physician on… more
- Bassett Healthcare (Cooperstown, NY)
- …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Intensive Care unit is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Provider, Social Work, Occupational Therapy, Restorative Therapy, Dietitian, and Psychologist. Review the interdisciplinary plan of care with all team members during… more
- Vighter Medical Group (Detroit, MI)
- Flight Registered Nurse Site Lead (SL), Youngstown, OH Job Details Job Location CSI - Youngstown, OH - Detroit, MI Secondary Job Location(s) Akron, OH - Akron, OH; ... Warren, OH Position Type Full Time Education Level Registered Nurse (RN) Salary Range $50.00 - $50.00 Hourly Travel...repatriated to their countries of origin. The RN will review medical records to determine if detainees can fly… more