• Utilization Review Nurse

    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 ... comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (05/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    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 ... and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (06/28/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    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 ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/25/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse (40…

    State of Connecticut, Department of Administrative Services (New Haven, CT)
    Utilization Review Nurse (40 Hour) Office/On-Site Recruitment # 250715-5612FP-001 Location New Haven, CT Date Opened 7/22/2025 12:00:00 AM Salary $78,480 - ... is seeking a highly motivated and compassionate U tilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) to join our team!… more
    State of Connecticut, Department of Administrative Services (07/23/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Registered…

    Emory Healthcare/Emory University (Atlanta, GA)
    …Ongoing mentorship, _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 more
    Emory Healthcare/Emory University (07/19/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    Dignity Health (Carmichael, CA)
    **Responsibilities** **Day Per Diem Utilization Review Registered Nurse - Onsite Campus Position** The ** Utilization Review RN** is responsible for ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
    Dignity Health (07/25/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (07/29/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse ( Utilization

    Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
    …members of the interdisciplinary team. Responsibilities Duties include but not limited to: Utilization Review (UR) Registered Nurse (RN) is responsible for ... Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion...or standing. Transferring patients and objects may be required. Utilization of safe patient handling and mobility protocols using… more
    Veterans Affairs, Veterans Health Administration (07/24/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Utilization

    LifePoint Health (Louisburg, NC)
    …a valid job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* ... Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound commitment… more
    LifePoint Health (05/15/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
    US Tech Solutions (07/18/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral… more
    US Tech Solutions (07/31/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF UTILIZATION ... policy, regulatory and accreditation guidelines. . Responsible for the review and evaluation of clinical information and documentation. ..... 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior… more
    US Tech Solutions (07/18/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …well-being of the unique communities we serve. **Summary:** This position facilitates utilization management processes to support the right care is provided at 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,… more
    UNC Health Care (06/05/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Review

    AmeriHealth Caritas (LA)
    …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... Degree in Nursing (BSN) preferred. + An active Registered Nurse (RN) license in good standing is required. +...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
    AmeriHealth Caritas (06/25/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
    Beth Israel Lahey Health (05/11/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Review

    AmeriHealth Caritas (Washington, DC)
    …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Current driver's license required… more
    AmeriHealth Caritas (06/03/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Registered…

    BJC HealthCare (St. Louis, MO)
    … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization more
    BJC HealthCare (07/12/25)
    - Save Job - Related Jobs - Block Source
  • RN- Utilization Review Weekender…

    Baptist Memorial (Meridian, MS)
    …Job Description Title: RN Utilization Review Weekender 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 works with providers, insurance… more
    Baptist Memorial (07/21/25)
    - Save Job - Related Jobs - Block Source
  • RN- Utilization Review

    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 works with providers, insurance companies… more
    Baptist Memorial (06/14/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review - Registered…

    Community Health Systems (Naples, FL)
    **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition ... improvement programs + Addresses facility and departmental communication through daily review of all correspondence, including incoming email messages. + Performs… more
    Community Health Systems (07/12/25)
    - Save Job - Related Jobs - Block Source