Utilization Review Nurse jobs

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RN/Case Manager/Per Diem
NCH HealthCare - Naples, FL
as a Registered Nurse in the State of Florida Certification in clinical case management of utilization review strongly desired. BSN preferred or equivalent...
Sponsored by NCH Healthcare - 30+ days ago
Admissions Nurse Navigator
Memorial Medical Center 124 reviews - Springfield, IL
The Admissions Nurse Navigator provides prospective and concurrent clinical review of patient records to evaluate the level of care and utilization of acute...
Sponsored by Memorial Medical Center - 30+ days ago

Nurse Medical Management I or II-FEP

WellPoint, Inc 428 reviews - Indianapolis, IN
Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable...
WellPoint - 20 hours ago - save job - email - more...

Utilization Review Nurse (Full Time) - Utilization Managemen...

Alaska Native Tribal Health Consortium 13 reviews - Anchorage, AK
Performs utilization review in accordance with all state mandated regulations. Maintains compliancy with regulation changes affecting utilization management....
3 days ago - save job - email - more...

Registered Nurse Utilization Review

Avera Health - Sioux Falls, SD
The Utilization Review RN reviews scheduled, concurrent and retrospective inpatient and outpatient cases to determine primary and secondary insurance...
9 days ago - save job - email - more...

Nurse Reviewer

HMSA 7 reviews - Honolulu, HI
Under minimal supervision, conducts detailed analysis and review of medical records and pre-authorization requests, applies clinical expertise, establishes...
Hawaii Medical Service Association - 6 days ago - save job - email - more...

Telephonic RN Case Manager - Work from home in MD

UnitedHealth Group 1,427 reviews - Baltimore, MD
View the Realistic Job Preview to learn more aspects of this job. http://uhg.hr/Telephonic_Case_Manager_UHCCS....
15 hours ago - save job - email - more...

Medical Review Examiner Nurse

CommunityCare, Inc. - Tulsa, OK
The Medical Review Examiner Nurse is responsible for auditing provider and facility claims against relevant medical records and documents....
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7 days ago - save job - email - more...

Utilization Review\Quality Assessment Analyst

Sharp HealthCare 53 reviews - San Diego, CA
The UR/QA Analyst reviews orders in Allscripts, i.e., plan of care, resumption of care, certifications, supp. orders, etc. to complete revenue cycle....
1 day ago - save job - email - more...

U/M Nurse

Quality Health Plans of New York - Ronkonkoma, NY 11779
QHPNY is looking for a Utilization Management Nurse with the following job duties:. • Reviews and collects medical information in order to determine the medical...
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1 day ago - save job - email - more...

Utilization Review Manager (Full time , Days, RN required)

Catholic Health Initiatives 90 reviews - Grand Island, NE
Performs the functions of Utilization Review Nurses as needed to maintain adequate saff and coverage for efficient operations....
11 days ago - save job - email - more...

Utilization Review RN, Care Coordination, FT, 9:00a-5:30p

South Miami Hospital 30 reviews - Miami, FL
Functions as the lead member of the care coordination team to ensure high quality patient care, appropriate length of stay, excellent resource utilization, and...
Baptist Health South Florida - 8 days ago - save job - email - more...
Admissions Nurse
Presbyterian Homes and Services 61 reviews - Brooklyn Center, MN
planning; and utilization review for all payer types, including Medicare, Managed Care and other third party payer systems. Qualifications Registered nurse...
Sponsored by Presbyterian Homes and Services - 8 days ago
Primary Nurse Case Admin I
HCSC 24 reviews - Albuquerque, NM
all functions of Utilization Management (UM), Case... in managing care. The Primary Nurse Coordinator performs concurrent review, discharge planning and care...
Sponsored by HCSC - 30+ days ago
Registered Nurse (RN) - Director of Case Management
Centra Healthcare Solutions - Dallas, TX
identification and utilization of available resources... utilization management program including daily admission and inpatient concurrent review processes for...
Sponsored by Centra Healthcare Solutions - 1 day ago
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