Utilization Review Nurse jobs

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Pediatric Care Coordination Registered Nurse - RN (Lakeland)
eQHealth Solutions - Lakeland, FL
Prospective Review Urgent/Non-urgent, Concurrent Review and Retrospective Review. Provides first level utilization review for all inpatient and outpatient...
Sponsored by eQHealth Solutions - 17 days ago
Review Nurse (NOW & COMP) - Atlanta, GA
Alliant Health Solutions - Atlanta, GA
Our review nurses do not work weekends, odd shifts or holiday hours. Currently we are seeking 2 Review Nurses to be responsible for the complete medical review...
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Sponsored by Alliant Health Solutions - 30+ days ago
Personal Health Consultant I - Work from Home
UnitedHealth Group 1,926 reviews - Denver, CO
Refer to and encourage participants' utilization of available community and other resources. As appropriate, encourage participants to regularly review...
Sponsored by UnitedHealth Group - 2 days ago
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Utilization Management Nurse Connsultant

LanceSoft Inc. - Maitland, FL 32751
It includes utilization review of worker's comp cases. Looking for RN with active RN license....
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Utilization Management RN

Dupage Medical Group 52 reviews - Downers Grove, IL
Performs concurrent review on medical patients, determines medical necessity by application of criteria per Utilization Management Dept Policy and specific...

Registered Nurse (RN)

Sono Bello 12 reviews - Garfield Heights, OH - +2 locations
RN is responsible to review two random charts per month per QA/QI peer review protocol. There will be two (2) random peer case reviews performed monthly per...

Clinical Decision Support Team RN Coordinator

Commonwealth Care Alliance 9 reviews - Charlestown, MA
Register Nurse licensed in the Commonwealth of Massachusetts. Conducts clinical decision review for services requiring prior authorization by the Clinical...

QUALITY IMPROVEMENT SPEC II

Covenant HealthCare 118 reviews - Saginaw, MI
Clinical chart review and abstraction experience required. Conducts the required chart reviews and enters into database....

RN, Care Manager

HealthCare Partners 75 reviews - Long Beach, CA - +5 locations
Previous care management, utilization review or discharge planning experience, HMO experience preferred. We are currently seeking a Registered Nurse, Care...

Retrospective Review Nurse

WellCare 109 reviews - Tampa, FL
Reviews medical records against PLP guidelines and recommends a case disposition. Identifies misuse of ER utilization and resources and communicates with...

RN/Healthy @ Home/Salary

Carolinas HealthCare System 148 reviews - Charlotte, NC
Reviews patient records monthly and participates in utilization and compliance reviews and substantiates in writing any deviation from care plan with...

Clinical Practice Consultant - Telecommuter - Northeast

UnitedHealth Group 1,926 reviews - New York, NY - +1 location
RN, Registered Nurse, Nurse, practice, private practice, clinical practice consultant,performance improvement, Analyze, strategies, operational, New York, New...

Registered Nurse (Utilization Management)

Department of Veterans Affairs 940 reviews - Harlingen, TX - +2 locations
As a Nurse assigned to Quality Management for Texas Valley Coastal Bend Health Care System, you will serve as the Utilization Management Clinician and will be...
RN Case Manager GHH Part Time
Galichia Heart Hospital 7 reviews - Wichita, KS
Performs utilization reviews and communicates information to third party payers. Daily responsibilities may include utilization review and/or discharge planning...
Sponsored by HCA Inc - 24 days ago
On Site RN Case Manager - Phoenix, AZ
UnitedHealth Group 1,926 reviews - Phoenix, AZ
Experience in utilization review, concurrent review or risk management. Nurse, RN, on site, field based, hospital, case management, CCM, utilization review,...
Sponsored by UnitedHealth Group - 15 days ago
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Company with Utilization Review Nurse jobs
eQHealth Solutions is a non-profit, multi-state medical management company that provides a wide range of solutions to our clients.