Utilization Review Nurse jobs

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RN-Utilization Review Specialist
Gulf Coast Regional Medical Center - Panama City, FL
Minimum of 3 years Utilization Review experience required. The primary purpose of the Utilization Review nurse is to serve as principal liaison between medical...
Sponsored by HCA Inc - 21 days ago
Nurse Clinician RN (Cross Functional)
Express Scripts 961 reviews - Warrendale, PA
Previous clinical criteria review experience preferred; The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...
Sponsored by Express Scripts - 30+ days ago
Manager, Utilization Management
New Directions Behavioral Health 6 reviews - Jacksonville, FL
Monitor staff for appropriateness and congruence of application of medical necessity criteria during utilization review process....
Sponsored by New Directions Behavioral Health - 13 days ago

Utilization Nurse

Lahey Health Behavioral Services 15 reviews - Tewksbury, MA
On a regularly scheduled basis, reviews all records for compliance with utilization review guidelines. Valid and current Massachusetts licensure as a Registered...

Utilization Review Nurse - Houston

Cigna 866 reviews - Houston, TX
Utilization Review Nurse - Houston. The Inpatient Review Nurse. Management Supervisor and Director of Inpatient Utilization Management, the Inpatient Review...

Utilization Review Nurse

Yukon-Kuskokwim Health Corporation 18 reviews - Bethel, AK
The UR Nurse will report on workload activity, challenges that prevent processing or approval of days, and provides decision support on opportunities for...

Utilization Review RN-Full-time

Piedmont Healthcare 114 reviews - Atlanta, GA
Three years Utilization or Case Management experience. Current License in the State of Georgia as a Registered Nurse....

Utilization Review Nurse

Aurora HealthCare 163 reviews - Kenosha, WI
Provides clinical updates for utilization to third party payors and fourth party external review groups, as stipulated in contractual agreements....

Utilization Management Authorization Nurse

Peoples Health, Inc. 14 reviews - Baton Rouge, LA
Answers pages and phone calls received from hospital utilization review regarding a patient’s condition during business hours....

Registered Nurse (RN)

Sono Bello 12 reviews - Garfield Heights, OH - +2 locations
RN is responsible to review two random charts per month per QA/QI peer review protocol. There will be two (2) random peer case reviews performed monthly per...

Registered Nurse- Utilization Management Nurse Consultant

Aetna 461 reviews - Richfield, OH
2 years utilization review and/ or discharge planning experience. Nursing/Registered Nurse (RN) is required. Click here to review the benefits associated with...

Utilization Review RN (Sheridan WY)

Sheridan Memorial Hospital 4 reviews - Wyoming
The Utilization Review Nurse performs utilization review of all patients presenting for hospitalization to assist in identifying patients appropriate for...

Retrospective Review Nurse

WellCare 109 reviews - Tampa, FL
Reviews medical records against PLP guidelines and recommends a case disposition. Identifies misuse of ER utilization and resources and communicates with...
Registered Nurse / RN / Care Coordinator
Longmont United Hospital 26 reviews - Longmont, CO
Utilization review, Medicare compliance, screening guidelines, discharge planning, quality measure monitoring....
Sponsored by Longmont United Hospital - 10 days ago
Nurse Disability Consultant
Lincoln Financial 34 reviews - Atlanta, GA
Educational experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management...
Sponsored by Lincoln Financial Group - 30+ days ago
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Company with Utilization Review Nurse jobs
961 reviews
Express Scripts is a Fortune 25 company and is the largest pharmacy benefit manager in the U.S.