Utilization Review Nurse jobs

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Travel Nurse - RN - ER Case Manager Registered Nurse
Fastaff 13 reviews - Los Angeles, CA
RN Case Manager, Nurse Case Manager, Registered Nurse (RN) Case Manager Jobs, Case Manager Travel RN, Case Manager Travel Nurse, Medical Case management,...
Sponsored by Fastaff - 23 days ago
Utilization Review Denials and Appeals Registered Nurse
Mary Washington Healthcare 44 reviews - Fredericksburg, VA
Minimum of one to three years of Case Management, Utilization Review, or prior experience with responding to utilization review denials, audits and appeals....
Sponsored by Mary Washington Healthcare - 16 days ago
Clinical Documentation Specialist
Swedish American Health System 7 reviews - Rockford, IL
RN (Registered Nurse) in State of Illinois. In collaboration with physicians, nurses, coding staff and members of the Health Care Team, reviews and evaluates...
Sponsored by Swedish American Health System - 30+ days ago

Utilization Reivew Nurse, Part Time

Health Choice 4 reviews - Phoenix, AZ
The Utilization Review Nurse completes inpatient admission and concurrent reviews for Health Choice members, considering Interqual criteria and other national...

Clinical Appeals Reviewer/Case Manager

Addison Healthcare 3 reviews - Houston, TX 77076 (North area)
A Houston LTAC Hospital Facility I work with is looking for an LVN/RN to work onsite and do their clinical appeals, auditing, and utilization review....
Easily apply

Medical Reviewer III

CGS Administrators - Nashville, TN
Provides support and review of medical claims and utilization practices. Active TN registered nurse licensure....

RN - Prior Authorization

HealthCare Partners of Nevada - Las Vegas, NV
One to two years experience in utilization review, high risk management, concurrent review, quality assurance, discharge planning or other cost management...

RN - Medicare Claims Reviewer (Illinois telework)

Catapult Consultants - Illinois - +6 locations
Catapult Consultants is hiring a Lead Claims Review Analyst to perform pre and/or postpay medical review workload for Medicare claims....

Utilization Review Nurse

Wisconson Healthcare - Milwaukee, WI 53227
Provides concurrent review and prior authorizations (as needed) according to companies policy for members as part of the Utilization Management team....
Easily apply

RN Utilization Review - Knoxville, TN

Humana 916 reviews - Knoxville, TN
Humana is seeking a Utlization Review Nurse who will collaborate with other health care givers in reviewing actual and proposed medical care and services...

UTILIZATION MGMT COORD

Lourdes Health System 3 reviews - New Jersey
To assure that all documentation related to Utilization Review including payer certification determinations, denials, expedited appeals, retrospective appeals,...

Utilization Management Nurse

Mercy Health - Cincinnati, OH
Interprets and applies clinical information to make delivery decisions and determine appropriate level of care for utilization review activities....

RN Utilization Management Louisville, KY

Anthem, Inc. 582 reviews - Louisville, KY
Outpatient and/or inpatient review preferred. Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of...
Utilization Management Nurse - Telecommute
UnitedHealth Group 1,987 reviews - Seattle, WA
Perform utilization management, utilization review, or concurrent review (on-site or telephonic inpatient care management)....
Sponsored by UnitedHealth Group - 22 days ago
Utilization Review Nurse (Medical/Behavioral Health – Psychi...
The HSC Health Care System - Washington, DC
Certification in utilization review preferred. The Utilization Review (UR) Nurse is responsible for the clinical review of pediatric and young adult members for...
Sponsored by The HSC Health Care System - 20 days ago
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Company with Utilization Review Nurse jobs
7 reviews
Swedish American is a not-for-profit, locally governed, healthcare system.