• 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 ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...implemented for compliance, as needed. + As a unit supervisor at the LA General Medical Center: + Has… 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 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 (03/30/25)
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  • Utilization Management Review

    AmeriHealth Caritas (Dover, DE)
    …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. + Availability to work Monday through Friday,… more
    AmeriHealth Caritas (04/29/25)
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  • 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 (05/21/25)
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  • Shift Care Utilization Review

    AmeriHealth Caritas (Philadelphia, PA)
    …us at www.amerihealthcaritas.com. **Responsibilities:** Under the direction of the unit Supervisor , the Clinical Care Reviewer- Shift Care is responsible for ... the case is presented to the Medical Director for medical necessity review . Upon approval of services, responsibilities include timely notification and education to… more
    AmeriHealth Caritas (05/22/25)
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  • Supervisor , Utilization Management

    Centene Corporation (Atlanta, GA)
    …perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review ... team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. **(Must reside in Georgia).** + Monitors and tracks UM… more
    Centene Corporation (05/21/25)
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  • Supervisor , Behavioral Health…

    Centene Corporation (Tallahassee, FL)
    …this leadership role, you'll provide guidance and oversight to a team of Utilization Review Clinicians focused on behavioral health prior authorizations.** **If ... you have experience in managed care, behavioral health utilization review , and leadership, we want to...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
    Centene Corporation (05/15/25)
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  • Registered Nurse Supervisor

    Louisiana Department of State Civil Service (Jennings, LA)
    REGISTERED NURSE SUPERVISOR A/WAE/PRN Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4939641) Apply  REGISTERED NURSE SUPERVISOR ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient… more
    Louisiana Department of State Civil Service (05/15/25)
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  • Registered Nurse Supervisor B

    Louisiana Department of State Civil Service (Reserve, LA)
    REGISTERED NURSE SUPERVISOR B Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947288) Apply  REGISTERED NURSE SUPERVISOR B Salary ... as, Nursing Policy and Procedure Committee, patient safety, quality assurance, and utilization review . Supervises the ordering of medical supplies and materials… more
    Louisiana Department of State Civil Service (05/22/25)
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  • Registered Nurse Supervisor A

    Louisiana Department of State Civil Service (Reserve, LA)
    REGISTERED NURSE SUPERVISOR A Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4947231) Apply  REGISTERED NURSE SUPERVISOR A Salary ... of subordinate nurses engaged in quality assurance, infection control, and utilization review activities. Receives physicians' instructions regarding patient… more
    Louisiana Department of State Civil Service (05/22/25)
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  • Registered Nurse Supervisor B

    Louisiana Department of State Civil Service (St. Gabriel, LA)
    REGISTERED NURSE SUPERVISOR B Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4950193) Apply  REGISTERED NURSE SUPERVISOR B Salary ... QUALIFICATIONS This position has a Special Entrance Rate Registered Nurse Supervisor A has an SER of$41.86...Policy and Procedure Committee, patient safety, quality assurance, and utilization review . Supervises the ordering of medical… more
    Louisiana Department of State Civil Service (05/22/25)
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  • Registered Nurse Supervisor 1 (NY…

    New York State Civil Service (Montrose, NY)
    …Mental Health Nurse , (including all parenthetic), Infection Control Nurse , or Senior Utilization Review Nurse ;Or 2. One year in any Grade 16 or ... NY HELP Yes Agency Health, Department of Title Registered Nurse Supervisor 1 (NY HELPS) (Veterans Home at Montrose) - 90208 Occupational Category Health Care,… more
    New York State Civil Service (05/21/25)
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  • RN Utilization Mgmt I

    Covenant Health Inc. (Knoxville, TN)
    …meetings between physicians and payors as applicable. + Completes daily work lists for utilization review meeting the time frames set forth by Covenant Health. + ... Overview Registered Nurse , Revenue Integrity & Utilization Management...to non-clinical precertification staff. + Assists with delayed claims review to determine appropriate number of observation hours as… more
    Covenant Health Inc. (05/19/25)
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  • Manager, Care Coordination (RN) - Emergency…

    Stanford Health Care (Palo Alto, CA)
    …- 3+ years of experience in case management - 3+ years of experience in utilization review Why work at Stanford Medicine | Stanford Health Care (SHC)? - ... on a rotating basis with other managers when on-call Supervisor is unavailable. + Develops and oversees relationships and...Knowledge of principles and best practices of case management, utilization review , social work, care coordination and… more
    Stanford Health Care (02/22/25)
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  • Nurse Manager 1 - Clarks Summit State…

    Commonwealth of Pennsylvania (PA)
    …I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or ... and Training Requirements: + Two years as a Registered Nurse Supervisor or three years as a...Work Behavior as a charge nurse , head nurse , utilization review nurse more
    Commonwealth of Pennsylvania (05/22/25)
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  • Registered Nurse , Acute Care - Emergency…

    Bassett Healthcare (Cooperstown, NY)
    …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Emergency Department is accountable for the ... needs. The RN contributes to the support of patients through interdisciplinary teamwork. Registered Nurse I: The RN I status is only appropriate for a new nurse more
    Bassett Healthcare (05/20/25)
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  • Registered Nurse , Acute Care - Labor…

    Bassett Healthcare (Cooperstown, NY)
    …delivery model includes specially trained nurses, operating technicians, certified nurse midwifes, board certified obstetricians, lactation consultants, and a ... specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Labor and Delivery/Obstetrics unit is accountable… more
    Bassett Healthcare (05/20/25)
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  • Community Care Registered Nurse

    Veterans Affairs, Veterans Health Administration (Reno, NV)
    …results to include with referral. Applying knowledge related to policy guidelines, utilization review criteria, and current evidence based standards of care. ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements,… more
    Veterans Affairs, Veterans Health Administration (05/22/25)
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  • Registered Nurse I, Acute Care - Medical…

    Bassett Healthcare (Cobleskill, NY)
    …enjoy the best quality of life possible. What you'll do The Registered Professional Nurse I, Acute Care is accountable for the delivery of safe patient care ... and job description is only appropriate for a new nurse in the first year of practice, as support...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes… more
    Bassett Healthcare (05/20/25)
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  • Registered Nurse Case Manager

    The Arora Group (Bethesda, MD)
    …+ Report to the Nurse Manager, and take direction from the charge nurse and house supervisor as required in maintaining a safe environment for staff ... Registered Nurse Case Manager Nurse Currently recruiting...cost diagnoses. + Independently perform difficult and complex assessment, review , coordination, planning, monitoring, evaluation and analysis of cases.… more
    The Arora Group (03/27/25)
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