Utilization Review Nurse jobs

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Utilization Review RN-possible 1 day per week remote or 4/10...
Cancer Treatment Centers of America 100 reviews - Atlanta, GA
Conducts documentation reviews for compliance and completeness. Registered Nurse with a minimum of three years clinical experience....
Utilization Management Nurse
AllyAlign Health, Inc - Richmond, VA
The primary role of the Utilization Management Nurse is to review and monitor members’ utilization of health care services with the goal of maintaining high...
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Utilization Review RN

Driscoll Children's Hospital 25 reviews - Corpus Christi, TX
The Utilization Review RN communicates with providers of care/services to ensure appropriate levels of care....

Utilization Review Nurse

McLaren Flint 18 reviews - Flint, MI
Current Michigan licensure as Registered Nurse. 3-5 years recent Case Management or Utilization Management experience....

Utilization Review Nurse I

HealthPlus of Michigan 10 reviews - Flint, MI
The Utilization Review (UR) Nurse ensures services meet member’s health needs and promotes the provision of high quality care in the most appropriate and cost...


Presbyterian Healthcare Services 60 reviews - Albuquerque, NM
Performs care review both prospectively and retrospectively. May perform, audits of entities delegated for utilization management functions....

Oasis Review Nurse - Sugarloaf

Visiting Nurse Health System - Georgia
Reviews visit utilization for appropriateness as per care guidelines and patient condition; The Oasis Review Nurse provides up front review of admission...

Telephonic Utilization Management Nurse - Daytona Beach

Humana 1,108 reviews - Daytona Beach, FL
Conduct admission review, post-discharge calls and discharge planning. Previous experience in utilization management, discharge planning and/or home health or...

RN Medical Reviewer III

BlueCross BlueShield of South Carolina 26 reviews - Augusta, GA
Provides support and review of medical claims and utilization practices. Performs medical reviews using clinical/medical information provided by physicians...

On Site Case Management Coordinator

Blue Cross Blue Shield of IL, MT, NM, OK & TX 2 reviews - Houston, TX
Utilization management experience. This position conducts on-site reviews and assessments, reviews service requests, collects clinical and non-clinical data,...

Regional Nurse Consultant-Brigid Health Services

Consulting Support Services - Lakeland, FL
Regional Nurse Consultant. Assists communities with medication assistance/administration and pharmacy utilization trends....
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Pediatric CCS Review Nurse

River City Medical Group 2 reviews - Sacramento, CA 95831 (Greenhaven area)
The review nurse will monitor, process and identify and resolve issues independently. Experience in utilization management and/or quality management, preferred....
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Utilization Review Nurse, RN
Christian Health Care Center 24 reviews - Wyckoff, NJ
Monitors physician ordered support services for appropriate over/under utilization. Must be a Registered Nurse in the state of New Jersey....
Case Manager/Utilization Review RN - FT - $5K Sign On Bonus
Piedmont 11 reviews - Atlanta, GA
Follow Medicare guidelines regarding utilization review (Condition Code 44, 2MN Rule, etc). Utilization across the continuum....
Clinical Care Reviewer Utilization Management (RN)
AmeriHealth Caritas 77 reviews - Harrisburg, PA
Current Unrestricted Pennsylvania Registered Nurse License required. Reviews inpatient and outpatient services requiring Plan approval;...
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