Utilization Review Nurse jobs

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Utilization Management (RN) - $5K Signing Bonus
Evolent Health 10 reviews - Indianapolis, IN
Performs Telephonic prospective, concurrent and retrospective utilization reviews. The Utilization Management Care Advisor will be responsible for assuring the...
Utilization Review RN-possible 1 day per week remote or 4/10...
Cancer Treatment Centers of America 100 reviews - Atlanta, GA
Conducts documentation reviews for compliance and completeness. Registered Nurse with a minimum of three years clinical experience....
Quality Assurance Nurse
Guardian Angel Health Care - Rochester Hills, MI
$90,000 a year
Review evaluation documentation. Review proposed 485 edits. Transfer to inpatient facility - review and approve new order, review assessment data, edit, lock...
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Utilization Review Nurse

Unite Here Health - Las Vegas, NV
Experience in transplant utilization review or experince as a transplant nurse required. Experience in Utilization Review including prospective, concurrent and...

Registered Nurse - Care Manager/Utilization Review

Providence Health & Services 190 reviews - Olympia, WA 98507 (Indian Creek area)
Perform resource utilization review studies in collaboration with medical records and quality management staff....

Registered Nurse

Sono Bello 17 reviews - Lake Success, NY  +5 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...

CASE MANAGER Case Management Casual Day

Scripps Health 180 reviews - La Jolla, CA  +1 location
Three years experience in case management/utilization review, discharge planning or home health case management preferred....

Care Coordinator - Utilization Review (Full Time Days)

Colorado (Grand Junction) - St. Mary's Hospital an... - Grand Junction, CO
Collaborates with the Utilization Review RN in ensuring appropriate level of care and efficient utilization of services throughout the patient's stay....

Telephonic Nurse Consultant

Selective Insurance Group - Charlotte, NC
Demonstrated knowledge and practical application of conducting utilization review activities specific to state regulations....

Clinical Resource Specialist

Saint Joseph Regional Medical Center 674 reviews - Mishawaka, IN
$24.30 - $36.60 an hour
Reviews and recommends contracts to the Director for review by the Value Analysis Teams. Monitors product utilizations for standardization opportunities....

Appeals Nurse Analyst

Johns Hopkins Health Care 282 reviews - Glen Burnie, MD
Knowledge of Interqual Milimen & Roberts or other utilization review tools; Providing resources to non-clinical staff in review of administrative denials or...

RN Care Case Manager

ABCBS 17 reviews - Little Rock, AR  +1 location
$57,900 a year
Utilization Management (Pre-cert./Pre-notification). Arkansas Registered Nurse with current license and in good standing with clinical practice experience....

Care Advisor Nurse

Patient First 94 reviews - King of Prussia, PA  +1 location
Utilization review and call center experience a plus; Helping develop new members of the nurse call center; The responsibilities of the job include, but are not...
Utilization Review Nurse, RN
Christian Health Care Center 24 reviews - Wyckoff, NJ
Monitors physician ordered support services for appropriate over/under utilization. Must be a Registered Nurse in the state of New Jersey....
Utilization Review Nurse
Mercy 116 reviews - Des Peres, MO
Assessment/Referral and Utilization Management:. Prepares and refers cases to Medical Director for review appropriately....
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