Utilization Review Nurse jobs

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Sr. Review Coordinator (RN)
Telligen 11 reviews - West Des Moines, IA
Must be a Registered Nurse. Coordinates and participates in peer-to-peer review as warranted. Knowledge of acute inpatient, therapy services, durable medical...
Sponsored by Telligen  - 30+ days ago
Behavorial Health Nurse Navigator
Chippenham Hospital 12 reviews - Richmond, VA
Current Virginia Registered Nurse. Conducts reviews in a timely and accurate manner. Experience providing nursing assessment and care, discharger planning, and...
Sponsored by HCA Inc  - 30+ days ago
Registered Nurse - RN Transition Navigator - Baton Rouge
Ochsner Health System 70 reviews - Baton Rouge, LA
UTILIZATION MGMT OBR-3350. Experience in discharge planning, social services, home health, managed care, case management or utilization review preferred....
Sponsored by Ochsner Health System  - 1 day ago

Utilization Management Pre-Service Review Nurse - Iowa

Meridian Health Plan 42 reviews - Des Moines, IA - +3 locations
Functions collaboratively with the members of the Utilization Management team, and specifically with the inpatient review nurses, Case Managers, Utilization...

Review Nurse - Surveillance Utilization Review Nurse (SURS)

Alliant Health Solutions - Atlanta, GA 30346
Currently, we are seeking a Review Nurse for our Surveillance Utilization Services (SURS) team. As a member of a professional multi-disciplinary work team, the...
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Utilization Management Representative I - Atlanta, GA - 8/3...

Anthem, Inc. 600 reviews - Atlanta, GA 30301(Buckhead area) - +1 location
Refers cases requiring clinical review to a Nurse reviewer. Utilization Management Rep I. Responsible for coordinating cases for precertification and prior...

Front End Review Nurse ? Utilization Management

Humana Inc. 955 reviews - Louisville, KY
Front End Review Nurse ? Humana is seeking a Front End Review Nurse who will collaborate with other health care givers in reviewing actual and proposed medical...

Nurse Utilization Management - Memphis, TN - #106004

Anthem, Inc. 600 reviews - Memphis, TN 37501(Parkway Village-Oakhaven area)
Nurse Utilization Management / Nurse Medical Management. Conducts pre-certification, continued stay review, care coordination, or discharge planning for...

Grievance and Appeals Nurse Specialist

CalOptima 7 reviews - Orange, CA
The Grievance and Appeals Nurse Specialist participates in managing the organization’s State Hearing review for all lines of business;...

Preservice Review Nurse RN - Work from home in Tennessee

UnitedHealth Group 2,057 reviews - Nashville, TN
Utilization review, utilization management, RN, Telecommute, Work from home, TN, Tennessee. Perform prior authorizations, utilization and concurrent reviews...

Utilization Management Transition RN

AllCare Management Services - Grants Pass, OR
The RN will perform on-site reviews of current inpatient and outpatient services by following medical guidelines and benefit determination....

RN, Case Manager - Park Ridge Health, Full Time Days

Park Ridge Health 19 reviews - Hendersonville, NC
Initiate and maintain ongoing utilization review based upon knowledge of Integral screening criteria for all payers....

Utilization Review Nurse

PRIME HEALTHCARE SERVICES HQ - Ontario, CA 91761
Performs utilization review in accordance with all state and federal mandated regulations. Current California Registered Nurse License required....
Call Center Nurse (RN PREFERRED) - Tampa, FL - #105467
Anthem, Inc. 600 reviews - Tampa, FL
2 years of clinical or utilization review experience. Review of claim edits, pre-noted inpatient admissions or, episodic outpatient therapy such as physical...
Sponsored by Anthem, Inc.  - 4 days ago
Travel Case Manager RN/Case Manager Registered Nurse
Medical Staffing Network 332 reviews - Portland, OR
Hospital case management utilization review experience. Current state registered nurse license. Travel Case Manager RN/Case Manager Registered Nurse....
Sponsored by Medical Staffing Network  - 30+ days ago
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