RN Utilization Review jobs

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Utilization Review RN Evening $5K Sign-On Bonus
Three years Utilization or Case Management experience. The purpose of this position is to ensure that acute hospital admission have the appropriate level of...
Sponsored by Piedmont
Care Advisor Nurse
Patient First - 92 reviews - Glen Allen, VA
Utilization review and call center experience a plus; The responsibilities of the job include, but are not limited to, the following:....
Sponsored by Patient First
Utilization Review Nurse
Aspire Health Plan - Monterey, CA
RN. The Utilization Review Nurse will:. Active RN license. Participate in quality audits, chart audits, and reviews of medical records as needed for either...
Sponsored by Aspire Health Plan

Recovery Specialist, Healthcare Provider Review

University of Massachusetts Medical School - 49 reviews - Charlestown, MA
Core activities of this unit include compliance with the Surveillance Utilization Review Subsystem (SURS), development and running of algorithms and conducting...

Clinical Quality Reviewer

HMS - 425 reviews - United States
This person is responsible for complex quality reviews to determine if decision by review staff matches medical records and approved review methodologies....

Prior Authorization Nurse I

Centene Corporation - 245 reviews - North Charleston, SC  +15 locations
Current state’s RN license. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors...

Medicare Case Manager (RN) - Torrance, CA (work at home)

Humana - 1,044 reviews - Torrance, CA
Previous experience in utilization management, case management, discharge planning and/or home health or rehab....


Meridian Health - 39 reviews - Holmdel, NJ 07733  +1 location
Performs retrospective clinical reviews. Performs admission review within 24 hours or the first business day and continued stay reviews every 3 days or as...

Peoria-Clinical Documentation Improvement Specialist-Methodi...

UnityPoint Health - 13 reviews - Peoria, IL
1-3 years of experience in/with clinical documentation improvement/utilization review preferred. Needs to be a strong clinical nurse looking to work M-F...

Registered Nurse (RN) Utilization Management (UM) Nurse Cons...

Aetna - 570 reviews - High Point, NC  +1 location
The Utilization Management Nurse Consultant will:. The Utilization Management Nurse Consultant will utilize clinical skills to evaluate and review information...

CDI Specialist - (RN Required Case Management exp. preferred...

Complex Care Hospital at Ridgelake - Sarasota, FL
RN with bachelor’s degree in a related field. This position provides integration of the patient’s condition with the medical record documentation, facilitates...

Manager, Utilization Management (RN)

Centene Corporation - 245 reviews - Troy, MI
Compile and review multiple reports on work function activities for statistical and financial tracking purposes to identify utilization trends and make...

Clinical Advisor CM

Humana - 1,044 reviews - Irving, TX
Performing prospective, concurrent, retrospective, and on-site reviews in a timely and efficient manner and certifying care in accordance with LifeSynch...
HEDIS / QARR Chart Review Consultant (RN)
Execu | Search - 45 reviews - New York, NY
$150 a day
Unemployed or contract RNs / LPNs / Foreign MDs with a Managed Care, Quality Improvement, Performance Improvement, Case Management, Chart Review, Utilization...
Sponsored by Execu | Search
Utilization Review RN - Case Management - PT - Days
Three years Utilization or Case Management experience. The purpose of this position is to ensure that acute hospital admission have the appropriate level of...
Sponsored by Piedmont

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Company with RN Utilization Review jobs
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