Utilization Review Nurse jobs

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Clinical Documentation Specialist
Swedish American Health System 5 reviews - Rockford, IL
RN (Registered Nurse) in State of Illinois. In collaboration with physicians, nurses, coding staff and members of the Health Care Team, reviews and evaluates...
Sponsored by Swedish American Health System - 21 days ago
Intake Nurse
Access Nursing Services 5 reviews - New York, NY
Collaborates with the hospital’s case managers, discharge planning personnel, utilization review. NY1, Intake Nurse, Intake RN, Intake Registered Nurse, UAS,...
Sponsored by Access Nursing Services - 22 days ago
Review Analyst R.N. -I
ABCBS 13 reviews - Little Rock, AR
Review guidelines established for the review of claims. Review, Claims Processing, or Customer Service. Review logic, contractual guidelines, and regulatory...
Sponsored by Arkansas Blue Cross and Blue Shield - 18 days ago


UnityPoint at Home - Urbandale, IA
Reviews SOC/ROC admits with Oasis for accuracy and service utilization and provides feedback to clinicians....

Registered Nurse (RN) - Utilization Management Clinical Cons...

Aetna 460 reviews - New Albany, OH - +3 locations
Click here to review the benefits associated with this position. The Registered Nurse (RN) Utilization Management Clinical Consultant utilizes their...

Clinical Quality Assurance Nurse Auditor

IME Resources - Redding, CA 96002 - +1 location
Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews....

Utilization Review Nurse - Medical Review

Johns Hopkins Health Care 231 reviews - Glen Burnie, MD
Medical Review URN:. The Utilization Review Nurse will be responsible for receipt, screening and authorization of pre-treatment/service inpatient and outpatient...

Nurse, Utilization Review

Methodist College - United States
Nurse, Utilization Review. JOB SUMMARY To provide concurrent and retrospective clinical review of inpatient medical records to evaluate the utilization of acute...

Appeals Nurse Reviewer - Managed Care

Florida Hospital Tampa- Adventist Health System - Tampa, FL
The Utilization Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), Inter....

Utilization Review\Quality Assessment Analyst

Sharp HealthCare 67 reviews - San Diego, CA
Current unencumbered CA Registered Nurse licensure. The department oversees quality, utilization, compliance, and education functions....

Medical Utilization Analyst

Horizon Blue Cross Blue Shield of New Jersey 32 reviews - Newark, NJ
Requires a Registered Nurse (RN) license. Requires a minimum of three years business/insurance experience with Utilization Review or medical chart auditing or...

Medical Review Nurse

NCI Information Systems, Inc. 123 reviews - Omaha, NE - +10 locations
As the Medical Review Nurse ( Medical Reviewer III ), you are responsible for conducting clinical reviews of medical records during the course of fraud...

Clinical Reviewer

CareCentrix - Tampa, FL
The core function is to review utilization information concerning patient care for Care. Follows Utilization Management and URAC standards....
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Utilization Review Nurse- Direct Placement
Maxim Healthcare Services 757 reviews - San Jose, CA
We are currently seeking Registered Nurses for a Utilization Review position at a prestigious healthcare facility in San Mateo, CA....
Sponsored by Maxim Healthcare Services - 30+ days ago
RN Clinical Reviewer
Home Care by Black Stone - Columbus, OH
Registered Nurse with an Ohio license. Reviews HIPPS/HRRG list weekly from billing and corrects. Access to utilization of public or private transportation...
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Sponsored by Home Care by Black Stone - 23 days ago
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Company with Utilization Review Nurse jobs
5 reviews
Swedish American is a not-for-profit, locally governed, healthcare system.