- GIBSON AREA HOSPITAL (Gibson City, IL)
- …Type Full Time Salary Range $32.00 - $48.00 Hourly Description JOB TITLE: UTILIZATION REVIEW /CASE MANAGEMENT - Nurse DEPARTMENT: CASE MANAGEMENT (QUALITY) ... GENERAL SUMMARY The Utilization Review /Case Management Nurse is directly...to interact with patients/families, healthcare providers, and outside agencies. Registered Nurse with at least two years… more
- Geisinger (Wilkes-Barre, PA)
- Job Title: RN - Graduate Registered Nurse (Geisinger Wyoming Valley, Wilkes-Barre)Location: Wilkes-Barre, PennsylvaniaJob Category: Inpatient RN - ... R-77849Job SummaryGeisinger is proud to offer a Graduate Inpatient RN up to $21,000 hiring incentive for eligible candidates!...during your entire first year as a GN!Job Description:The Registered Nurse assesses plans, organizes, performs, and… more
- Aveanna Healthcare (Birmingham, AL)
- $7500 Sign-On Bonus Position Overview: The Hospice Registered Nurse is responsible for pain management, symptom control in the delivery of care to hospice ... of care and patient needs. Participates in quality improvement, utilization review , and infection control activities as...Time, and Paid Holidays Qualifications: Current license as a Registered Nurse in the State of Alabama… more
- Providence Little Company of Mary Medical Center - San Pedro (San Pedro, CA)
- …Offering Nursing Profession RN Specialty Case Manager Job ID 33531206 Job Title Registered Nurse - Case Manager @ Providence Little Company of Mary Medical ... Date 12/08/2025 Duration 13 Week(s) Job Description Job Title: Case Manager Profession: Registered Nurse Specialty: Case Management Duration: 13 weeks Shift: Day… more
- SR International, Inc. (Phoenix, AZ)
- …obtain their own laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote/Onsite Trainings) Skills Required: *Medical nursing practice, ... times for training once starting position Compliance Items: Active RN License in state of Arizona Fingerprint Clearance Card...medical case management protocols, quality management and utilization review protocols as related to all… more
- PharmaCord (Jeffersonville, IN)
- …clearly and articulately Have a positive attitude! Education & Experience: Licensed Registered Nurse 2-3 years nursing with experience in rare disease, ... healthcare industry is required Bachelor's degree required; Master's degree is preferred Nurse line triage, Call Center Utilization Management, Call Center Case… more
- Sprenger Wellspring Silver Maple (Lorain, OH)
- …Home Health - Lorain, OH Job Shift Any Description JOB TITLE: Licensed Practical Nurse REPORTS TO: Registered Nurse BASIC PURPOSE A clinically competent, ... on ongoing home visits and reports these to the registered nurse . In conjunction with the ...summaries within 48 hours of the patient discharge. Resource Utilization Ascertains knowledge of patient pay source and make… more
- Tenethealth (Frisco, TX)
- …(2) years supervisory experience CERTIFICATES, LICENSES, REGISTRATIONS Preferred: Active state Registered Nurse license or Certified Coding Specialist credential ... annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding… more
- 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 (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
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator Office/On-site Recruitment # 250910-5613FP-001 Location East Hartford, CT Date Opened 9/15/2025 12:00:00 AM Salary ... (https://portal.ct.gov/dds/searchable-archive/northregion/north-region/welcome-to-the-north-region?language=en\_US) - is accepting applications for a full-time Utilization Review Nurse Coordinator… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...and offerings. Education/Experience: + Unrestricted state license as a Registered Nurse required; BSN preferred. + 3+… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical ... of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a...beneficiary and the Network Provider. + Provides first level RN review for all outpatient and ancillary… more
- CDPHP (Latham, 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
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review * **Location:**… more
- University of Utah Health (Salt Lake City, UT)
- …and 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
- Dayton Children's Hospital (Dayton, OH)
- …timeHours:8Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical record review for ... medical guidelines and communicates information to payers in accordance with contractual obligations. The Utilization Review RN serves as a resource to the… more
- 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 (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
- 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
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