- Ascension Health (Manhattan, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Pipeline Health System, LLC (Toast, NC)
- Job Title: Utilization Review Registered Nurse - Behavioral Health Unit/FT/Days Job Summary: This Utilization Review (UR) Registered Nurse ... compassionate care to our patients. This position is responsible for utilization review , assessment of discharge planning needs and coordination of effective… more
- Ascension Health (Birmingham, AL)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- Trinity Health (Syracuse, NY)
- …days shift with every 6th weekend. Med Surg experience preferred. **Position Purpose:** The Registered Nurse Utilization Review (UR), Clinical Care ... Manger (CCM) actively manages the utilization review process and patient progression from...to all patients in accordance with the New York Nurse Practice Act, National Standards of Practice, and Nursing… more
- The Arora Group (Bethesda, MD)
- …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse (RN) and pre-certification ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in… more
- HCA Healthcare (Nashville, TN)
- …want your knowledge and expertise! **Job Summary and Qualifications** **As a Utilization Review Services Registered Nurse , you will focus on initial and ... **Description** **Introduction** Do you have the career opportunities as a(an) Utilization Review Nurse BH WFH you want with your current employer? We have… more
- ERP International (Corpus Christi, TX)
- **Overview** ERP International is seeking a ** Registered Nurse (RN)** ** Utilization Manager** for a full-time position in support of the **Naval Health ... range of utilization management services including referrals, care coordination, utilization review , discharge planning, continued stay reviews, and appeal… more
- Crouse Hospital (Syracuse, NY)
- Utilization Management Registered Nurse has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization ... + EDUCATION / CERTIFICATION / LICENSURE + Required: + Currently licensed as a Registered Professional Nurse in New York State. + Associates Degree + Preferred:… more
- McLaren Health Care (Detroit, MI)
- …accordance with established SOP procedures. 4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of ... **Department: Utilization Management** **Daily Work Times: 7:00am-3:30pm** **Shift: Days**...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- Cedars-Sinai (Los Angeles, CA)
- …thereafter as a condition of continued employment. **Req ID** : 5044 **Working Title** : Registered Nurse - Utilization Management 8 Hour Days Per Diem ... us one of America's Best Hospitals! **What You Will Do in This Role:** The Utilization Review Case Manager validates the patient's placement to be at the most… 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 $113,309.04 -… more
- Sutter Health (Burlingame, CA)
- …**EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN- Registered Nurse of California Upon Hire CCM certification preferred ... and case management within a managed care environment. Comprehensive knowledge of Utilization Review , levels of care, and observation status. Awareness of… more
- Dartmouth Health (Lebanon, NH)
- … Utilization Management is responsible for day to day operations of the utilization review program at multiple Dartmouth Health system hospitals covering a ... leadership, communication and computer skills desired. Required Licensure/Certifications - Licensed Registered Nurse with NH eligibility - BLS certification… 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
- R1 RCM (Pittsburgh, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. **Title: Utilization Review Nurse ** **Location: Hospital Client ... vary and some flexibility may be offered** As our ** Utilization Review Nurse ** , you...other opportunities that promote growth. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Independent Health (Buffalo, NY)
- …first-class perks, benefits and commitment to diversity and inclusion. **Overview** The Utilization Review Nurse performs clinical reviews to determine ... criteria or IHA policy. **Qualifications** + Active, current, unrestricted, and licensed registered nurse required. Associates degree in health related field;… more
- US Tech Solutions (Chicago, IL)
- …you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About ... + 3+ years of experience as an RN + Registered Nurse in state of residence +...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Milford Regional Medical Center (Milford, MA)
- …services to our community with dignity, compassion, and respect. Statement of Purpose: The Utilization Review Nurse is responsible for utilization ... Minimum of 1 year Nurse Case Management experience Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse 2 uses clinical knowledge, communication skills,… more
- 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