RN Utilization Review jobs

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Nurse-Utilization Review
RN - Registered Nurse. The utilization review nurse will monitor the patient's progression in their plan of care and perform continue stay reviews to ensure...
Clinical Documentation Improvement Specialist
Utilization review and / or coding experience preferred. Review and analysis of health records to identify relevant diagnoses....
UNC Health Care - 221 reviews - Chapel Hill, NC
UTILIZATION MANAGER - CARE MANAGEMENT. To complete admission, continued stay, and discharge reviews in accordance with federal regulations and the Hospitals'...

Indianapolis CONTRACT Utilization Review RN – Managed Care

CareNational Healthcare Services (CNHS) - Indianapolis, IN 46204
$30 an hour
CONTRACT Utilization Review RN – Managed Care*. The Utilization Review Nurse is responsible for utilization management in the form of prospective, concurrent,...
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UM Nurse Consultant

Aetna - 1,927 reviews - Chantilly, VA  +12 locations
Click here to review the benefits associated with this position. The nurse uses clinical skills to coordinate, document and communicate all aspects of the...

Telephonic Skilled Inpatient Care Coordinator (SICC)

naviHealth - 24 reviews - New Jersey
When naviHealth is delegated for utilization management review refer requests that cannot be approved for continued stay and are forwarded to licensed...

Per Diem-Nurse Auditor

Auto Injury Solutions - 23 reviews - Remote
Perform utilization review per client directed criteria. (1) Bill Review Solutions, which involve the review of first party medical claims, (2) Medical Advisory...
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RN Nurse Medical Management I/II Utilization Management

Anthem, Inc. - 1,879 reviews - Atlanta, GA 30319  +1 location
RN Nurse Medical Management I/II Utilization Management – Onsite Piedmont Fayette Hospital Fayetteville, GA 125222....

Lead Medical Review RN

Quality Health Strategies - 8 reviews - Orange, CA
Healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, CPT coding, and knowledge of Medicare and/or Medicaid...
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Nurse Reviewer - Utilization

WNS Global Services - 1,180 reviews - Columbia, SC
$58,000 - $62,000 a year
RN:. One or more years’ experience in utilization review. Review Medical Advisory Solutions, which include nurse case management, physician reviews, hospital...
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Nurse Medical Management I or II (MMP)

Anthem, Inc. - 1,879 reviews - Texas
Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure...

Concurrent Review Nurse I - Philadelphia

Pennsylvania Health & Wellness - Philadelphia, PA
Current state’s RN license. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors...

Contingent Care Utilization Review Coordinator RN

Kaiser Permanente - 4,141 reviews - Cupertino, CA
Reviews utilization patterns, identifies trends and problems areas for special studies. Conducts utilization review for in-house patients and/or those members...
RN Weekends - Part time - 2 12's. $5,200k Retention Bonus
This RN may also serve as the case manager, which involves the identification of appropriate services, supervision of home health aide staff and ongoing review...
Utilization Management Prior Authorization Registered Nurse
MCCI Medical Group - San Antonio, TX
Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according to guidelines....
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