• Utilization Review Nurse

    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
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse

    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
    The County of Los Angeles (03/30/25)
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  • Utilization Review Nurse

    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 ... 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
    Houston Methodist (06/06/25)
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  • Utilization Review Nurse

    R1 RCM (Detroit, MI)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform...ten-hour shifts Friday to Monday. **Required Skills:** + Active Registered Nurse ( RN ) license in… more
    R1 RCM (05/23/25)
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  • 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 ... 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 (06/04/25)
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  • RN Utilization Management/…

    Elevance Health (Morgantown, WV)
    RN Utilization Management/ Review Nurse - InPatient Medicaid (JR155056) **Location:** This position requires you to **reside in the state of West ... Monday through Friday, 8am - 5pm The **Medical Management Nurse ** (Medicaid Utilization Review ) is...an equivalent background. + Current active, valid and unrestricted RN license to practice as a health professional within… more
    Elevance Health (06/11/25)
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  • Registered Nurse Utilization

    LifePoint Health (Louisburg, NC)
    Registered Nurse ( RN ) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound ... as an employee but as a person. As a registered nurse ( RN ) joining our...a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review more
    LifePoint Health (05/15/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (05/30/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
    US Tech Solutions (04/18/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
    Albany Medical Center (04/25/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1...months of Prior Authorization. Education: . Active and unrestricted RN licensure in state of residence **About US Tech… more
    US Tech Solutions (04/18/25)
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  • Utilization Review Nurse

    Dignity Health (Mesa, AZ)
    …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... + Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
    Dignity Health (06/12/25)
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  • 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 ... the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech… more
    US Tech Solutions (05/17/25)
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  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …EXPERIENCE REQUIREMENT** + Five (5) years of health care experience as a Registered Nurse . **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a ... the unique communities we serve. **Summary:** This position facilitates utilization management processes to support the right care is...Registered Nurse in the state of North Carolina. **KNOWLEDGE, SKILLS… more
    UNC Health Care (06/05/25)
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  • Utilization Review

    Community Health Systems (Naples, FL)
    …meet deadlines. + Effective written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **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… more
    Community Health Systems (04/25/25)
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  • Utilization Management Review

    AmeriHealth Caritas (Washington, DC)
    …Associate's Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred. + A Registered Nurse ( RN ) license in the District of Columbia in ... efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
    AmeriHealth Caritas (06/03/25)
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  • Case Manager Utilization Review

    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
    Beth Israel Lahey Health (05/11/25)
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  • RN - Utilization Review

    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
    Baptist Memorial (04/22/25)
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  • 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...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
    Baptist Memorial (06/14/25)
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  • Pediatric Shift Care Utilization Management…

    AmeriHealth Caritas (Philadelphia, PA)
    …between 8:30a EST and 5:00p EST.** ; + Current, active, and unrestricted Registered Nurse licensure in Pennsylvania. + Associate Degree in Nursing. Bachelor ... preferred. + Minimum of 3 years of experience providing direct patient care;as a Registered Nurse working with medically fragile pediatric patients in a clinical… more
    AmeriHealth Caritas (05/22/25)
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