- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… 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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center,...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... resource to the physicians and provides education and information on resource utilization and national and local coverage determinations (LCDs & NCDs). This position… more
- Actalent (Sunrise, FL)
- Actalent is hiring UM nurses!Job Description The Utilization Management Nurse (UMN) plays a crucial role in optimizing the utilization of healthcare ... UMN reviews service authorization requests to ensure appropriate service utilization . This includes reviewing specialties, medical treatments, elective hospital… more
- Access Dubuque (Dubuque, IA)
- Utilization Management Nurse **Medical Associates** 1 Positions ID: oQ7fwfws Posted On 06/05/2025 **Job Overview** **Description** Medical Associates is looking ... for a ** Utilization Management Nurse ** to join our Health Care Services team! **Schedule:** Primary schedule will be Monday through Friday 8:00am to 5:00pm, 40… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary… more
- Actalent (Des Moines, IA)
- Job Title: Utilization Management Nurse Job Description **Must reside in Iowa or South Dakota** The Utilization Management Nurse is responsible for ... assisting in discharge planning while making referrals for ongoing needs. The nurse will work collaboratively with healthcare providers to gather medical information… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... remote position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform initial admission and continued stay reviews utilizing… more
- Actalent (Des Moines, IA)
- Utilization Management Nurse - Job Description**Must reside in Iowa or South Dakota** This role involves providing members and healthcare providers with timely ... quality assurance and production metrics as established for the utilization management unit. Essential Skills + Registered Nurse... utilization management unit. Essential Skills + Registered Nurse (RN) or Licensed Practical Nurse (LPN)… more
- Humana (Charleston, WV)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Humana (Louisville, KY)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... services and/or benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments are varied and… more
- CDPHP (Albany, NY)
- …share 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 ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization... Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Ongoing mentorship and leadership programs + And more! **Description** The **Registry Utilization Review Nurse ** (PRN) is responsible for conducting medical ... attending physician and/or physician advisor. + The UR RN (PRN) will perform utilization review by completing a timely and comprehensive review of all new… more
- Elevance Health (Morgantown, WV)
- RN Utilization Management/Review Nurse - InPatient Medicaid (JR155056) **Location:** This position requires you to **reside in the state of West Virginia.** ... Hours** : Monday through Friday, 8am - 5pm The **Medical Management Nurse ** (Medicaid Utilization Review) is responsible for review of the most complex or… more
- Commonwealth Care Alliance (Boston, MA)
- …CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is ... and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in providing ... : Certified/certification eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses; Certification in… more
- LifePoint Health (Louisburg, NC)
- …job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* **Requisition ... Registered Nurse (RN) Utilization Review Job Type:...Registered Nurse (RN) Utilization Review Job Type: Full Time | Day...an employee but as a person. As a registered nurse (RN) joining our team, you're embracing a vital… more
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for UM reviews for patients who receive hospital care. Responsibilities An UM ... Registered Nurse is responsible for UM reviews and use of...performance measures. Uses emergency and bed management software and utilization data to manage admission recommendations and identify barriers… more
- Beth Israel Lahey Health (Plymouth, MA)
- …years recent, broad clinical experience in the hospital setting + Experience with utilization management within the last 3 years required + An understanding of the ... severity of an array illnesses, intensity of service, and care coordination needs + Ability to identify appropriateness of patients admission and level of care needs (inpatient & observation) utilizing Interqual criteria + Knowledge of Interqual required;… more
- WellSpan Health (York, PA)
- …geographic footprint._** **General Summary** Performs a variety of reviews and applies utilization and case management techniques to determine the most efficient use ... and quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible for screening patients for… more
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