- The County of Los Angeles (Los Angeles, CA)
- …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …_development,_ and leadership programs + And more **Description** The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible ... for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be an expert in the utilization review … more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
- Actalent (Sunrise, FL)
- Job Title: Utilization Review NurseJob Description The Utilization Management Nurse (UMN) collaborates closely with the interdisciplinary team to perform ... complex cases, develops internal processes, and educates physicians on utilization review issues. The role involves managing...care Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year… more
- Commonwealth Care Alliance (Boston, MA)
- …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
- Actalent (Sunrise, FL)
- Utilization Management Nurse !Job Description The ...on department activities as assigned. Essential Skills + Clinical review + Utilization review + ... record Additional Skills & Qualifications + Current unrestricted Florida RN or LPN License. + Minimum of one year...or LPN License. + Minimum of one year of utilization review experience and discharge planning in… more
- Beth Israel Lahey Health (Burlington, MA)
- …in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / ... **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review Full Time Days - 2506001461 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...Conditions of Participation and Tenet policies Operates within the RN scope of practice as defined by state licensing… 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 ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Baptist Memorial (Meridian, MS)
- Overview RN Utilization Review Weekender Job...Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible for ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...experience Preferred/Desired: RN with Case Management or Utilization Review experience in a hospital or… more
- HCA Healthcare (Nashville, TN)
- …individual is recognized. Submit your application for the opportunity below:Behavioral Health Utilization Review RN MSW Parallon. **Benefits** Parallon, ... Eligibility for benefits may vary by location._** We are seeking a Behavioral Health Utilization Review RN MSW for our team to ensure that we continue to… more
- Beth Israel Lahey Health (Plymouth, MA)
- …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
- Dignity Health (Sacramento, CA)
- **Responsibilities** The ** Utilization Review RN ** is responsible for the review of medical records for appropriate admission status and continued ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...with physicians, payers, Care Coordinators and other stakeholders regarding review outcomes. + Collaborates with facility RN … more
- Centene Corporation (Austin, TX)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... BHEC if you hold a LPC, LCSW, or LMFT. Registered Nurse can hold Texas State Licensure...preferred. + Knowledge of mental health and substance abuse utilization review process is preferred. + Experience… more
- Baptist Memorial (Memphis, TN)
- Overview Purpose of Position and Scope of Responsibility Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
- Catholic Health Initiatives (Omaha, NE)
- … Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive ... **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize… more
- AdventHealth (Glendale Heights, IL)
- …60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...capacity to prioritize multiple tasks and role components. + Registered Nurse ( RN ) Required +… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral health and substance use ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
- Ascension Health (Wichita, KS)
- **Details** + **Department:** Utilization Review + **Schedule:** Full time, 36 hrs, Day shift, 7:30 AM- 4:00 PM, Monday-Friday, rotating weekends possible + ... Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests… more