Utilization Review Nurse jobs

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Utilization Review Nurse
Mercy - 218 reviews - Chesterfield, MO
The Utilization Review Nurse is responsible for the development, implementation, coordination, and follow-up of projects related to Mercy Care Management....
Registered Nurse (RN)--Utilization Review
Utilization Review Nurse. The Utilization Review Nurse performs medical necessity reviews on all commercial payor admissions to obtain authorization for care...

Clinical Reviewer - LPN/RN

KePRO - 26 reviews - United States
One to two years' experience in utilization review, high risk management, concurrent review, quality assurance, discharge planning or other managed care...

Nurse Reviewer, Utilization 3

Mitchell International, Inc. - 3 reviews - Texas
Mitchell’s Nurse Reviewers are Registered Nurses and will typically have at least 3 years clinical experience and one year within utilization review....

OASIS Review Nurse

Capitol - 22 reviews - Austin, TX 78758 (North Austin area)
$70,000 - $80,000 a year
Reviews visit utilization for appropriateness of care guidelines and patient condition; Registered Nurse (RN)....
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Utilization Management Rep I

Anthem, Inc. - 2,160 reviews - Indianapolis, IN  +3 locations
Refers cases requiring clinical review to a Nurse reviewer. Utilization Management Rep I:. Responsible for coordinating cases for precertification and prior...

RN Acute Utilization Management – NC, SC, VA

Humana - 2,721 reviews - Charlotte, NC 28210 (Quail Hollow area)
Acute UM experience – medical necessity reviews. Active RN license in the state(s) in which the nurse is required to practice....

Prior Authorization Nurse

UnitedHealth Group - 5,546 reviews - Wakefield, MA 01880  +4 locations
Utilization Management experience. Perform / support clinical appeals (e.g., notes, previous reviews, obtain rationales) RN....

Health Planning & Support Telephonic RN - Work at Home

Humana - 2,721 reviews - San Antonio, TX 78229
Previous case management or utilization review. Humana is seeking a Health Planning and Support (HPS) nurse to provide Humana members with general nurse advice;...

National Nurse Reviewer

Auto Injury Solutions - 29 reviews - Iselin, NJ
Perform utilization review in accordance with AIS structure. (1) Bill Review Solutions, which involve the review of first party medical claims, (2) Medical...

RN / Registered Nurse - Utilization Management - Full Time -...

ProMedica - 61 reviews - Toledo, OH 43606 (Ottawa area)
The UM nurse reviews clinical. Nurse uses effective utilization management, resource. Utilization Management (UM) nurses work to maximize the....

Inpatient Utilization Review Nurse

Piper Clinical Solutions - Baltimore, MD
$85,000 a year
Responsibilities for the Inpatient Utilization Review Nurse:. Is seeking a motivated *Inpatient Utilization Review Nurse*....
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Utilization Management Nurse Consultant
Aetna - 2,277 reviews - New Albany, OH 43054
Registered Nurse is required. Utilization Management Nurse Consultants utilize clinical skills to coordinate, document and communicate all aspects of the...
Utilization Review Nurse
Virginia Mason - 101 reviews - Seattle, WA 98127
Experience in utilization review:. Performs a review of the clinical assessment for medical necessity for all hospitalized patients using utilization review...
RN - Utilization Review Specialist - 100% FTE, Day
UW Health - 57 reviews - Madison, WI
Recent experience as an inpatient utilization review nurse or UM coordinator. The Utilization Review (UR) Specialist has well-developed knowledge and skills in...
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