• The University of Vermont Health Network (Plattsburgh, NY)
    Unit Description: The Utilization Review Team monitors, collects and analyzes data and evaluates variances of resource utilization , complications and overall ... and promotes the efficient and effective use of patient services. The Utilization Review Team's role in data collection, analysis and summarization supports the… more
    JobGet (06/01/24)
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  • Saint Francis Health System (Tulsa, OK)
    Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job in Tulsa, Oklahoma.Job Description & RequirementsSpecialty: Virtual ... location (not a remote position)Will perform admit, discharge chart review and other patient care duties from an office...via secure virtual link to patient rooms.#RNSINDJob Summary: The Registered Nurse I (Virtual) assesses, plans, implements… more
    JobGet (06/03/24)
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  • Registered Nurse

    Glens Falls Hospital (Glens Falls, NY)
    …**Job:** **Nursing - Case Management* **Title:** * Registered Nurse - Utilization Review Nurse - Care Management * **Location:** *NY-Glens Falls* ... utilization management, or payer experience preferred. *Licenses, Certifications, Registrations:* * Registered Nurse (RN) in New York State *Skills and… more
    Glens Falls Hospital (04/26/24)
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  • Licensed Practical Nurse (LPN)…

    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
    The Arora Group (05/24/24)
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  • Utilization Management Plan Oversight…

    AmeriHealth Caritas (Newark, DE)
    ** Utilization Management Plan Oversight Manager, Registered Nurse (must reside in DE)** Location: Newark, DE Primary Job Function: Medical Management ID**: ... + Assist in preparation, coordination, and participation in and follow up of Utilization Management audits, such as readiness review , Data Validation, CMS… more
    AmeriHealth Caritas (05/08/24)
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  • Registered Nurse

    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
    McLaren Health Care (04/16/24)
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  • Utilization Review Nurse

    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
    The County of Los Angeles (04/02/24)
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  • Registered Nurse

    University of Washington (Seattle, WA)
    …artistic pursuits, and natural beauty. Requirements: Current license to practice as a Registered Nurse in the State of Washington. Minimum of three years ... Req #: 228720 Department: HARBORVIEW - UTILIZATION MANAGEMENT Posting Date: 05/03/2024 Closing Info: Open... Management Specialist RN2 is responsible for the ongoing review of a designated group of patients through the… more
    University of Washington (05/23/24)
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  • Registered Nurse 2…

    New York State Civil Service (Albany, NY)
    NY HELP Yes Agency Corrections and Community Supervision, Department of Title Registered Nurse 2 Utilization (NY HELPS) Occupational Category Health Care, ... Possession of a license and current registration as a registered professional nurse in New York State;...clinical nursing experience of which one year was in utilization review and/or discharge planning. Substitution: a… more
    New York State Civil Service (05/24/24)
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  • Remote Pre-Access Utilization Management…

    Insight Global (New York, NY)
    Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
    Insight Global (05/14/24)
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  • RN - Registered Nurse Senior…

    Geisinger (Danville, PA)
    …re-admissions. + Assesses and recommends policies as they relate to readmissions and utilization review activities. + Reviews inpatient level of care and ... of 5 years-Health Insurance/Managed Care (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic… more
    Geisinger (05/26/24)
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  • Utilization Review Nurse

    Beth Israel Lahey Health (Burlington, MA)
    …Medical Center is now offering up to a $3,500 in signing bonuses for our Utilization Review positions. Important Details: * Signing Bonuses are paid out in three ... Description:** **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate… more
    Beth Israel Lahey Health (04/17/24)
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  • Utilization Review Nurse (40…

    State of Connecticut, Department of Administrative Services (Hartford, CT)
    Utilization Review Nurse (40 Hour) Office/On-Site Recruitment # 240604-5612FP-002 Location Hartford, CT Date Opened 6/5/2024 12:00:00 AM Salary $76,565 - ... is seeking a highly motivated and compassionate U tilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) to join our team!… more
    State of Connecticut, Department of Administrative Services (06/06/24)
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  • Utilization Review Nurse

    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 the Utilization ... requiring clinical review prior to payment. The Utilization Review Nurse will use...License(s) and/or Certification(s): + Unrestricted state license as a Registered Nurse + Certification in managed care… more
    Martin's Point Health Care (05/15/24)
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  • Utilization Review Nurse

    CDPHP (Albany, 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 ... constituents on CDPHP guidelines, policies, and procedures. QUALIFICATIONS + Registered Nurse or Licensed Practical Nurse...acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization more
    CDPHP (05/20/24)
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  • Utilization Review Nurse

    R1 RCM (Detroit, MI)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform...ten-hour shifts Friday to Monday. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (06/03/24)
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  • Utilization Review Nurse

    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
    Milford Regional Medical Center (03/30/24)
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  • Utilization Management Nurse

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …discharge between levels of care and facilities Essential Qualifications + Current licensed Registered Nurse (RN) in good standing. Must retain active licensure ... + Adaptive to a high pace and changing environment. + Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
    Brighton Health Plan Solutions, LLC (05/23/24)
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  • Utilization Review Nurse

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …The Role BHPS provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical ... Outpatient, DME, and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse (RN) with state licensure. Must retain active and… more
    Brighton Health Plan Solutions, LLC (05/23/24)
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  • Utilization Review Nurse

    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
    Albany Medical Center (05/08/24)
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