Utilization Review Nurse jobs

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Case Manager
Mercy 109 reviews - Chesterfield, MO
Refers cases for Medical Director review as outlined by Utilization Management plan and Mercy Care Management policies and procedures....
Sponsored by Mercy
Clinical OASIS Reviewer / Home Health Coder
Wellness Healthcare Partners - Chicago, IL
Reviews visit utilization for appropriateness of care guidelines and patient condition; Licensed Clinician, preferably a Registered Nurse, with current license...
Easily apply
Sponsored by Wellness Healthcare Partners
Corporate Quality Nurse (RN)
Community Health Group 12 reviews - Chula Vista, CA
Experience in Quality Management, Utilization Management preferred. Will maximize CHG’s quality scores by performing chart review in provider offices to assure...
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Sponsored by Community Health Group

Clinical Utilization Management Nurse Reviewer

Robert Half Management Resources 3 reviews - Minneapolis, MN 55402 (Downtown West area)
The Clinical Utilization Management Nurse Reviewer is responsible for the analysis of trends, which may be identified through the review of cases, and for...

MMIC - Registered Nurse (RN) Utilization Management Clinical...

Aetna 552 reviews - Phoenix, AZ 85003 (Central City area)
Utilization Review (UR) / Utilization Management (UM) experience. The Utilization Management (UM) Clinical Consultant will:....

Utilization Management Review Nurse

Chinese Hospital 2 reviews - San Francisco, CA 94133 (Russian Hill area)
Utilization Management Nurse Reviewer. The Nurse reviewer performs on-site, written or telephonic assessments and utilization review, across the continuum of...
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Discharge Planner Nurse Reviewer

Health Partners, Inc. - Philadelphia, PA
Licensed Registered Nurse, must have an active license to practice professional nursing in the Commonwealth of Pennsylvania., 2 years medical/surgical,...

Utilization Review Nurse

Yukon-Kuskokwim Health Corporation 19 reviews - Bethel, AK
The UR Nurse will report on workload activity, challenges that prevent processing or approval of days, and provides decision support on opportunities for...

Concurrent Review Nurse, RN

Centene Corporation 238 reviews - Tacoma, WA  +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...

RN, Care Manager

HealthCare Partners 93 reviews - Costa Mesa, CA  +3 locations
Previous care management, utilization review or discharge planning experience. We are currently seeking a Registered Nurse, Care Manager:....

Authorization Nurse - UPMC Corporate Services

UPMC 302 reviews - Pittsburgh, PA
Prior utilization review experience. Maintain collaborative relationships with utilization management and departments at payor organizations....


Universal Health Services - Reno, NV
Utilization Review experience preferred. UTILIZATION REVIEW COORDINATOR PER DIEM. The Unit Review Coordinator provides admission and continued stay reviews in...

RN Nurse Case Manager - Mid-Valley - Harlingen, Texas

Cigna 968 reviews - Harlingen, TX  +2 locations
Knowledge of utilization review requirements and procedures. Provides clinical assessments, health education, and utilization management to customers....
Registered Nurse Case Manager - Case Management (Days) - Met...
Methodist Texsan Hospital - San Antonio, TX
Prefer at least one year experience in utilization review, resource management, discharge planning or case management....
Sponsored by HCA Inc
Utilization Reviewer (Medical)
The HSC Health Care System - Washington, DC
Certification in utilization review preferred. Licensed as Registered Nurse (RN) in Washington, DC. Two years of experience in utilization management in a...
Sponsored by The HSC Health Care System
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