Utilization Review Nurse jobs

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Medical Review Nurse

NCI Information Systems, Inc. - Omaha, NE  +1 location
As the Medical Review Nurse ( Medical Reviewer ) at the Omaha, NE office or remote for AdvanceMed, you will be responsible for conducting clinical reviews of...

Care Transitions Nurse Reviewer

Medical Mutual of Ohio 42 reviews - United States
Registered Nurse with 3 years recent nursing experience. Manages initial, concurrent, and retrospective review of cases, including appeals....

Care Advisor Nurse

Patient First 93 reviews - Fairfax, VA  +2 locations
Utilization review and call center experience a plus; Helping develop new members of the nurse call center; The responsibilities of the job include, but are not...

Utilization Management Coordinator

Granville Health System - Oxford, NC
Utilization Review Nurse. The primary role of the Utilization Review Nurse is to review and monitor members' utilization of health care services with the goal...

Patient Care Coordinator

Humana 1,057 reviews - San Antonio, TX
Utilization Review/Quality Management experience. Perform accurate and timely assessment and concurrent review of outlier admissions using InterQual criteria...

Nurse Reviewer - Part Time

Blue Cross Blue Shield of Rhode Island 18 reviews - Providence, RI
Certified Case Management certification, Certified Professional Utilization Review certification. Apply all aspects of the medical review function, including...

Case Management Nurse

Madera Community Hospital 30 reviews - Madera, CA
Performs Utilization Review Assessments, contacting physician and reporting appropriately. CA Registered Nurse License....

Case Mgr RN

Kaiser Permanente 2,627 reviews - Vallejo, CA  +2 locations
This review is on a position-by-position basis and includes an analysis of the actual duties performed in each position under review....

Clinical Review Specialist, RN - Retrospective Review

Arkansas Foundation for Medical Care 5 reviews - Fort Smith, AR
Quality Assurance / Utilization Review and/or coding experience, QIO experience. Seek direction from Review Manager, Clinical Director, Associate Medical...

Medical Review Nurse Auditor (Coder)

Performant Financial Corporation 4 reviews - San Angelo, TX
Conduct medical chart reviews. 2+ years direct experience in medical chart review for all provider/claim types inpatient/outpatient....
RN-Audit Coordinator
Memorial Medical Center of Las Cruces - Las Cruces, NM
Experience with Utilization Review helpful. The Nurse Auditor acts as a resource person for utilization management of patient care, denials, appeals and managed...
Sponsored by Memorial Medical Center of Las Cruces
Utilization Review RN Evening $5K Sign-On Bonus
Piedmont Healthcare 130 reviews - Atlanta, GA
Three years Utilization or Case Management experience. Current License in the State of Georgia as a Registered Nurse....
Sponsored by Piedmont
Nurse Utilization Management (Inpatient) I, II & Sr. Job Fam...
Anthem, Inc. 638 reviews - Tampa, FL
Nurse Utilization Management (Inpatient) I, II & Sr. Conducts pre-certification, continued stay review, care coordination, or discharge planning for...
Sponsored by Anthem, Inc.

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Company with Utilization Review Nurse jobs
For more than a century, Piedmont Healthcare has been a recognized leader in delivering expert care.