- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate,...+ The Contractor shall perform pre-cert and authorization of insurance pertaining to patient admission and surgical admission as… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-Site Recruitment # 240516-5613FP-001 Location Middletown, CT Date Opened 5/17/2024 12:00:00 AM Salary ... serve. THE POSITION: We are currently seeking a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=undefined&R3=undefined) to join our… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40 Hour) Office/On-site Recruitment # 240514-5612FP-001 Location New Haven, CT Date Opened 5/16/2024 12:00:00 AM Salary $76,565* - ... Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) as a Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) ! We are recruiting… more
- 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 NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization Review Team and ... for services requiring clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies as well as specified… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people,… more
- Trinity Health (Columbus, OH)
- …Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** The Utilization Review Nurse ensures that authorization requests and provider or member ... In collaboration with providers and the Medical Director, the Utilization Review Nurse ensures medical appropriateness and effective utilization of… more
- Centene Corporation (Tucson, AZ)
- …flexibility. **Must reside in Arizona!!** **Centene is currently seeking a remote Clinical Review Nurse -Concurrent Review to join their Arizona Medicaid ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Blue Cross and Blue Shield of Louisiana (Monroe, LA)
- …performance standards is required **Licenses and Certifications** + Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure Must be a ... Registered Nurse with a current Louisiana license.required + Case Mgmt/Social...license.required + Case Mgmt/Social Services\CPUR - Cert Prof Util Review Must be attained within first 24 months in… more
- Centene Corporation (Tallahassee, FL)
- …requires a current Florida residency!!** **Centene is currently seeking a remote Clinical Review Nurse - Prior Authorization to join our team, focusing on ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- Centene Corporation (Cheyenne, WY)
- …teams on projects within utilization management as part of the clinical review team + Partners and works with Medical Affairs and/or Medical Directors ... diagnoses, prognoses, resources, and/or preferences + Manages and maintains concurrent review findings, discharge plans, and actions taken on member medical records… more
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and the ... requested services using clinical judgment and refer to Medical Directors for review depending on case findings. Functions & Job Responsibilities * The Utilization… more
- Centene Corporation (Oklahoma City, OK)
- …or RN licensure. **Position Purpose:** Drafts correspondence letters based on review outcomes in accordance with National Committee for Quality Assurance (NCQA) ... management to identify and implement opportunities for improvement. + Performs clinical review of outcomes including creating and editing denial letters with the… more
- Intermountain Health (Murray, UT)
- …Marketplace Qualified Health Plans and commercial health plans. Utilization review behavior health professional proactively manage inpatient and outpatient ... be verified. + Current working knowledge of Medicare, Medicaid and Commercial insurance . + Current working knowledge of utilization management and case management… more
- NJM Insurance (Trenton, NJ)
- …line of business by performing prospective and retrospective Utilization Review of pharmaceutical/medication requests in accordance with regulatory guidelines, where ... and causally related. + Evaluate requests that are routed for clinical review based upon established criteria to issue appropriate and timely determinations on… more
- Bassett Healthcare (Cooperstown, NY)
- …realistic goal setting and remediation as monitored by staff feedback and supervisor review The Nurse Supervisor - Dialysis and Home Dialysis consistently ... as monitored by patient feedback, staff feedback, and supervisor review . The Nurse Supervisor - Dialysis and...holidays, vacation, and sick time Medical, dental and vision insurance Life insurance and disability protection Retirement… more
- Bassett Healthcare (Cooperstown, NY)
- …discuss specific positions in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Dialysis units 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 (Cooperstown, NY)
- …with no more than 2-3 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. The Registered Nurse II, Acute Care ... with no more than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation. The Registered Nurse II, Acute Care… more
- University of Colorado (Aurora, CO)
- Part-time Clinical Research Nurse (0.6 FTE) - 32974 University Staff **Description** **University of Colorado Anschutz Medical Campus** **School of Medicine | ... | Division of Infectious Disease** **Job Title: Part-time Clinical Research Nurse (0.6 FTE)** **Position: #00820766 - Requisition: #** **32974** **Job Summary:**… more
- State of Colorado (Delta, CO)
- CDOC Mid Level Provider / Nurse Manager - (Delta - Rifle) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4484358) Apply CDOC Mid Level ... Provider / Nurse Manager - (Delta - Rifle) Salary $8,364.00 -...Short and long term disability coverage; + Paid life insurance ; + 11 paid holidays per year plus vacation… more