- Island Health (Anacortes, WA)
- Island Health is seeking an experienced Utilization Review Registered Nurse for our hospital in Anacortes, WA. Work Schedule: 0.1 FTE / 0 hours per week ... Reimbursement Employee Assistance Program Employee Recognition Events And More! Utilization Review Registered Nurse Job Responsibilities: Identifies… more
- Medical Solutions (Omaha, NE)
- A facility in Detroit, MI is seeking its next amazing RN ( Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this sounds like ... your perfect fit! Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam, travel… more
- VCU Health (Richmond, VA)
- The Utilization Review RN is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review . ... team, including physicians, social workers, discharge planning assistants and payers. The Utilization Review RN performs reviews of current inpatient services,… more
- Capital Health (Trenton, NJ)
- …Three years of clinical nursing or two years quality management, utilization review or discharge planning experience. Other Credentials: Registered Nurse ... review and determination. Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis. Performs… more
- Surgery Partners (Altoona, WI)
- APPLICATION DEADLINE: 07/26/2025 Job Summary: The Registered Nurse - Utilization Review oversees and coordinates utilization review functions. ... ensuring physician and nurse documentation meet set standards Understand utilization review /case management rules and guidelines to ensure compliance The… more
- Franklin Woods Ctr (Rosedale, MD)
- …seeking a skilled and detail-oriented Registered Nurse - Utilization Management (UM) to review healthcare services, ensure clinical appropriateness, and ... Franklin Woods Ctr Job Type Travel Offering Nursing Profession Registered Nurse (RN) Specialty Utilization ...(RN) license in the state of practice. Experience in utilization management, case management, or clinical review … more
- Corvel (Fort Worth, TX)
- The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and ... worker's compensation claims preferred EDUCATION & EXPERIENCE: Must maintain current licensure as a Registered Nurse in the state of employment with a minimum of… more
- Iconma LLC (Detroit, MI)
- Our Client, a Health Insurance company, is looking for a Registered Nurse - Review Analys for their Detroit, MI/Hybrid location. Responsibilities: Perform ... which may include acute patient care, discharge planning, case management, and utilization review , etc. Demonstrated clinical knowledge and experience relative… more
- Luminis Health (Lanham, MD)
- …to hiring, evaluating performance, issuing final disciplinary actions under the review of Human Resources, and recommending discharge in collaboration with members ... environmental changes. *Assists others in prioritizing patient care. 2. 2. Nurse -Patient Family Relationships *Expertly provides direct patient care to patients and… more
- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …Function as Utilization Review /Denials Manager as required. Qualifications Registered Nurse (RN) with a Texas license; relevant certification (CCM, ACM, ... review , and transitions to prevent readmissions. Liaise with medical staff, utilization review , social services, payors, and community providers. Track and… more
- DHR Health (Edinburg, TX)
- …compassion, knowledge, innovation, integrated care and excellence. POSITION SUMMARY: The Utilization Review Supervisor coordinates, supervises and is accountable ... as projects and initiatives that can help the department's financial goals. The Utilization Review Supervisor develops programs for their staff in required… more
- Mount Sinai Hospital (New York, NY)
- …EDUCATION REQUIREMENTS Licensure: New York State License with current registration as a registered nurse . State Certification: Certified by the New York State ... the plan of care. 11. Performs a patient record review with the collaborating physician in a timely fashion...as follows: Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Healthcare Staffing Plus (Boston, MA)
- The registered nurse , adheres to the rules and regulations of the Massachusetts Board of Registration in Nursing. is primarily responsible for professional ... and their families across the health care continuum. The registered nurse is accountable for clinical, educational,...recommended script in the patient medical record for provider review and approval. Schedule appointments for the primary care… more
- Wellstar Health System (Roswell, GA)
- …conferences, interdisciplinary rounds, and patient/family education Collaborates effectively with the utilization review nurse , patient's physicians and the ... North Fulton Hospital has an opportunity for a Senior Registered Nurse (RN) Care Coordinator - PRN...needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates… more
- Texas Health and Human Services Commission (Austin, TX)
- …thinking skills. Registrations, Licensure Requirements or Certifications: Licensed to practice as a registered nurse (RN) in the State of Texas (or state that ... more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: Nurse III Job Title: Nurse III Agency: Health & Human Services Comm… more
- Zenex Partners (San Pedro, CA)
- …2 years of Acute Care experience (can consider 1.5 years) Experience with Utilization Review and Discharge Planning Experience with InterQual 1st-time travelers ... All RTO must be submitted upfront Requirements:… more
- AW Health Care (St. Louis, MO)
- …Additional Life Insurance) Job Summary: We are seeking a compassionate and skilled Registered Nurse (RN) to provide intermittent in-home nursing care in ... in peer review and performance improvement as assigned. Participates in utilization review of medical records as assigned. Gives total patient care… more
- WVU Medicine (Ranson, WV)
- …Below, you'll find other important information about this position. The professional registered nurse has the authority, responsibility, and shift accountability ... delivery of nursing care through the use of the nursing process. The Registered Nurse accepts accountability, applies competent clinical knowledge skills, and… more
- Prisma Health (Columbia, SC)
- …in Nursing. Bachelor's degree in Nursing preferred. Experience - One (1) year experience as a registered nurse . In Lieu Of In lieu of one (1) year of ... a sign-on bonus of $7,500 for external candidates. Please review details here. Prisma Health Heart and Vascular Institute...registered nurse experience, will accept successful completion… more
- Methodist Health System (Omaha, NE)
- …Intensive Care Unit (ICU) experience. License/Certifications Required: Current valid Nebraska Registered Nurse (RN) License, valid compact multistate license to ... or handling excreta from patients who have received hazardous medications. 9. Review , delegate and evaluate plans for appropriate utilization of staff… more
