Concurrent Review Case Management jobs

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Concurrent Review Nurse I (Sunrise)
Centene Corporation - 581 reviews - Holiday, FL 34691
Case Management experience. Utilization Management experience. Complete medical necessity and level of care reviews for requested services using clinical...
Utilization Review RN 1, Case Management, FT, 8A-4:30P
Utilization Review or Case Management Certification required within 12 months of hire. Case Management/Home Health....
Concurrent Review Nurse I (Field-Based)
Centene Corporation - 581 reviews - Gainesville, FL 32635
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
Registered Nurse - Case Management Specialist
Performs retrospective case reviews; Performs utilization review functions relating to BCBS Concurrent Utilization Review Program (CURP)....

Utilization Review Nurse (Local/Remote)

ezURs.com Inc - Dallas-Fort Worth, TX
Performs quality assurance review of peer review reports, correspondences, addendums or supplemental reviews. 1-2 of related clinical nursing or case management...
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Care Management Nurse

McBee - Remote
Minimum 3 years of case management/ concurrent review/ utilization management experience is required, preferably within the ED setting....
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Physician Advisor-Remote-PART TIME WEEKENDS

XSolis - Nashville, TN
Assist with the denial management process. Utilization management experience as a member of. Additional education in quality and utilization management through....
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Sr. Utilization review nurse (Remote)

Alvarez & Marsal - 31 reviews - Phoenix, AZ 85016 (Camelback East area)
Perform utilization management, utilization review or concurrent review (inpatient care management). 3 or more years of Utilization Review experience in Managed...

Registered Nurse, RN, Utilization Management Nurse - WellMed

UnitedHealth Group - 9,964 reviews - Shiner, TX   +5 locations
Utilization Review / Management experience. Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according...

Inpatient Utilization Review Nurse

Piper Companies - 4 reviews - Baltimore, MD
$85,000 a year
Case Management or Utilization Management experience required. Responsible for concurrent reviews including admission, continued stay, and short stay claims and...

Medical Appeals Review Nurse

Piper Companies - 4 reviews - Baltimore, MD 21201 (Downtown area)
$85,000 a year
Responsible for concurrent and post-pay review, with accurate and appropriate clinical documentation. Coordinates outpatient services per case....

Case Manager Social Worker

Mission Regional Medical Center - 46 reviews - Mission, TX
Develops case management recommendations consistent with sound medical and financial management. Experience preferred, minimum 3 years clinical and 1 case...

Patient Care Coordinator, On-Call

Kaiser Permanente - 6,080 reviews - Richmond, CA
Previous case management experience preferred. Develops and maintains case management policies and procedures. Coordinates, directs, and performs concurrent and...

Coordinator Patient Care-Continuing Care

Kaiser Permanente - 6,080 reviews - Wailuku, HI   +1 location
Minimum two (2) years of experience in utilization review, case management, and discharge planning. Performs daily pre-admission, admission, and concurrent...
Utilization Review RN 1, Case Management, FT, 8:30A-5P
Utilization Review or Case Management Certification required within 12 months. Position is to conduct initial, concurrent, retrospective chart review for....
Concurrent Review Nurse I (Gainesville)
Centene Corporation - 581 reviews - Maitland, FL 32751
Recent Concurrent Review or Utilization Management experience. Complete medical necessity and level of care reviews for requested services using clinical...