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

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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