Utilization Review Nurse jobs

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Clinical Learning Consultant (RN or LCSW)
Aetna 505 reviews - Detroit, MI
This includes the roles of Case Management Associate, Case Management Coordinator, Clinical Case Manager, UM Inbound Queue Rep, PA Nurse and Concurrent review....
Sponsored by Aetna
Case Manager/Utilization Review RN- PRN Jasper
Piedmont Healthcare 120 reviews - Jasper, GA
Utilization across the continuum. Georgia as a Registered Nurse. Evaluating medical necessity and appropriateness of scheduled and direct/emergent....
Sponsored by Piedmont Healthcare

Utilization Management Nurse

Utilization Management Nurse Utilization Managemen... - United States
Responsible for utilization of clinical and financial resources by:. Identifies and communicates to the Care Coordinator opportunities for more efficient...

RN Onsite Review Nurse – Kings Daughters Hospital - Ashland,...

Humana 953 reviews - Lexington, KY
Conduct admission review, post-discharge calls and discharge planning. Humana is seeking a RN Onsite Nurse who will collaborate with other health care givers in...

Claims Spec II, Workers Comp

Nationwide Mutual Insurance Company 798 reviews - Des Moines, IA - +1 location
Employs appropriate claims management techniques and direct intervention (I.e., independent medical examinations, referral for rehabilitation, utilization...

Telephonic Utilization Management RN - Telecommute

UnitedHealth Group 2,053 reviews - Milwaukee, WI
The Telephonic Utilization Management RN , sometimes referred to as a Utilization Management Nurse, is responsible for utilization management, utilization...

Utilization Management Specialist

WellSpan Health Services 66 reviews - York, PA
5 Supports the Utilization Management Nurse with case research and analysis. 2-3 years of Utilization Management Experience Preferred....

Clinical Care Plan Auditor

Magellan Health Services 149 reviews - Albuquerque, NM 87113(Alameda N Valley area)
Licensed nurse or mental health clinician, psychology?Experience:. ESSENTIAL FUNCTIONSReview the quality of and approve comprehensive care plans through review...

Medical Review Nurse Analyst

HP 3,896 reviews - Biddeford, ME
Medical Review Nurse Analyst. Utilization review background a plus. The DME MAC Medical Review Clinician will assist in meeting workload targets for Medical...

Concurrent Review Nurse I-Columbus

Centene Corporation 213 reviews - Columbus, OH - +5 locations
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...

Concurrent Review Nurse - Encino, CA

Conifer Value Based Care - Encino, CA
Concurrent Review Nurse - Encino, CA. Conifer Health Solutions is currently hiring for a Concurrent Review Nurse....

Advice Nurse - Regional Call Ct - M-F - 3:30PM - 12:00PM

Kaiser Permanente 2,387 reviews - Atlanta, GA
The Telephone Advice Nurse is an experienced registered nurse who utilizes the nursing process to evaluate patient needs over the telephone, adhering to...
Utilization Review Nurse (Medical/Behavioral Health – Psychi...
The HSC Health Care System - Washington, DC
Certification in utilization review preferred. The Utilization Review (UR) Nurse is responsible for the clinical review of pediatric and young adult members for...
Sponsored by The HSC Health Care System
Utilization Review Nurse
Integra Employer Health - Charlotte, NC
Registered Nurse or Licensed Practical Nurse:. Integra Health and Wellness is a leading regional Third Party Administrator providing medical management for self...
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Sponsored by Integra Employer Health
Call Center Nurse (RN PREFERRED) - Tampa, FL - #105467
Anthem, Inc. 599 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.
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For more than a century, Piedmont Healthcare has been a recognized leader in delivering expert care.