Utilization Review Nurse jobs

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NaviCare RN Clinical Manager -Raynham Office - Growing Elder...
Fallon Community Health Plan 23 reviews - Raynham, MA
External Quality Review Performance Improvement... work collaboratively with members of the FCHP Utilization management Department – assists the Supervisory...
Sponsored by Fallon Community Health Plan - 3 days ago
Manager, Utilization Mgmt.
FirstCare Health Plans 8 reviews - Lubbock, TX
review services. • Facilitates clinical review of... resource for the UM Nurses. • Performs quality assurance reviews on Utilization Management files to...
Sponsored by FirstCare Health Plans - 30+ days ago

RN - Utilization Management & Review Specialist

Castle Medical Center 6 reviews - United States
Reviews charts for purposes of insurance authorizations, monitoring length of stays, levels of care, to justify the medical necessity for hospitalization, using...
7 days ago - save job - block - email - more...

Utilization Review Nurse Case Manager - Hattiesburg, MS

Cigna 698 reviews - Hattiesburg, MS
Develops and maintains knowledge of provider organization review procedures. Maintains reporting system for Utilization Review....
5 days ago - save job - block - email - more...

RN - Utilization Review

United Hospital System - Kenosha, WI
Conducts utilization review in accordance with WIPRO and identifies and refers quality assurance problems. Performs other related duties as needed....
5 days ago - save job - block - email - more...

Medical Record Case Review Specialist

ANALYTICA - Henrico, VA
ANALYTICA is seeking a Medical Record Case Review Specialist that has experience working with case management of medical records, abstraction, and following...
Easily apply
9 days ago - save job - block - email - more...

Utilization Review Nurse

American International Group 345 reviews - Dallas, TX
Perform Utilization Review of workers' compensation claims, based on review criteria and protocols in accordance with state and regulatory agency compliance....
8 days ago - save job - block - email - more...

Utilization Management Nurse, OB

HealthSmart Care Management Solutions - Franklin, OH
The position involves coordination of services to improve and maintain quality patient care and appropriate utilization of resources....
HealthSmart - 13 days ago - save job - block - email - more...

RN/Healthy @ Home/Salary/Charlotte

Carolinas HealthCare System 112 reviews - Charlotte, NC
- Reviews patient records monthly and participates in utilization and compliance reviews and substantiates in writing any deviation from care plan with...
1 day ago - save job - block - email - more...

RN Complex Care Case Manager - Milwaukee, WI

UnitedHealth Group 1,513 reviews - Milwaukee, WI
View the Realistic Job Preview to learn more aspects of this job. http://uhg.hr/Telephonic_Case_Manager_UHCCS....
8 days ago - save job - block - email - more...

RN Coordinator- Inpatient Management

CCA 117 reviews - Boston, MA
Conduct telephonic preadmission clinical review of focused inpatient adm i ssi o ns with acute, rehabil i t ation an d s k il l e d nursing facilities....
Commonwealth Care Alliance - 14 hours ago - save job - block - email - more...

Medicare Case Manager (RN) - Dublin, OH

Humana 677 reviews - Dublin, OH
Humana is seeking a Case Manager who will collaborate with other health care givers in reviewing actual and proposed medical care and services against...
7 days ago - save job - block - email - more...
Phoenix Utilization Review Nurse (RN or LPN) – Managed Care
CareNational Healthcare Services, LLC - Phoenix, AZ
Utilization Review Nurse (RN or LPN) – Managed Care... The Utilization Review Nurse is responsible for utilization management and utilization review for... $63,000 - $75,000 a year
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Sponsored by CareNational Healthcare Services, LLC - 30+ days ago
CASE MANAGER RN
UNM Hospitals 6 reviews - Albuquerque, NM
care with physicians, nurses and other staff ensuring... assurance and utilization review, maintaining interdependent follow-up as necessary VARIANCE - Review...
Sponsored by UNM Hospitals - 11 days ago
RN Utilization Review
Tampa Community Hospital - Tampa, FL
Job Description RN Utilization Review(Job Number: 26535... accordance with Utilization Plan using ISD criteria, and performs concurrent stay reviews at least every...
Sponsored by HCA West Florida - 15 days ago
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