RN Utilization Review jobs

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Utilization Review Nurse
Mercy - 116 reviews - Des Peres, MO
Assessment/Referral and Utilization Management:. Active Missouri RN or LCSW license. Prepares and refers cases to Medical Director for review appropriately....
Medical Review Clinician
Medical Review Clinician (RN). Are you an ER, utilization review or primary care nurse, looking for an interesting opportunity to use your clinical skills, in...
Utilization Review RN-possible 1 day per week remote or 4/10...
Conducts documentation reviews for compliance and completeness. Utilization Management, Bill Audit, Case Management or Appeals and Denials experience preferred....


Epic Management - 11 reviews - United States
Concurrent review, utilization review, and telephonic review. The UM Nurse collects data, assists in organizing relevant data, collaborates with RN and MD, and...
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RN Medical Reviewer III

BlueCross BlueShield of South Carolina - 26 reviews - Augusta, GA
Provides support and review of medical claims and utilization practices. Active, unrestricted RN licensure from the United States and in the state of hire or...

Case Management & Utilization Review RN

Medical Service Organization - Hillside, IL
As a Case Management and Utilization Review RN, responsible for Care Management programs to ensure compliance, promote quality care, and effective cost savings...
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RN Pharmacy

Sedgwick Claims Management Services - 280 reviews - Coralville, IA  +4 locations
Performs drug utilization reviews through the pharmacy benefit manager or vendor. Active RN license(s) required....

Registered Nurse - Revenue Utilization Review Nurse

Department of Veterans Affairs - 1,200 reviews - Asheville, NC
Responsibilities of the Revenue Utilization Review Registered Nurse include the following:. Conducting SC reviews using Nuance and also assists with veteran...

Appeals Nurse Analyst

Johns Hopkins Health Care - 282 reviews - Glen Burnie, MD
Knowledge of Interqual Milimen & Roberts or other utilization review tools; Providing resources to non-clinical staff in review of administrative denials or...

Clinical Review Specialist

Healthways - 122 reviews - Sterling, VA
Utilization review, regulation, accreditation,. Initial clinical review and support of the Utilization Review, Grievance, and....

Continuing Care Utilization Review Coordinator RN, (Temporar...

Kaiser Permanente - 2,736 reviews - Fresno, CA
Reviews utilization patterns, identifies trends and problems areas for special studies. Conducts utilization review for in-house patients and/or those members...

Utilization Review Coordinator

Eastern State Hospital - 60 reviews - Williamsburg, VA
The Utilization Review Coordinator will provide timely, relevant, and accurate review of program documentation and processes at Eastern State Hospital (ESH)....

RN Frontline Leader - Utilization Review - Tampa, FL

Humana - 1,106 reviews - Tampa, FL
Current RN license. Previous experience in utilization management, discharge planning and/or home health or rehab....
Utilization Review RN
2 years experience required, RN licensure required, BA or BSN required (or working toward this goal), Masters preferred. Full time position....
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Utilization Review Nurse (Full-Time, Benefits)
Meritage Medical Network - Novato, CA
This position coordinates utilization review and case management activities for commercial and Medicare enrollees. Collaborates with the concurrent review....
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