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RN,Care Manager
Previous care management, utilization review,. Reviews patients' clinical. The Care Manager RN works. Decisions through utilization of appropriate reports:....
Coordinator, Utilization Review
Central Florida Health Alliance - Leesburg, FL
The Utilization Review Coordinator is responsible for determining the appropriateness of hospital admission; Utilization of resources and medical necessity for...
Utilization Management Nurse
Clover Health - San Francisco, CA
2-3 years experience in a hospital setting, acute care, direct care experience preferred OR experience as case manager, care coordinator, concurrent review...
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Nurse Reviewer-Remote

HMS - 470 reviews - Ohio  +1 location
1+ year utilization review experience. Unrestricted RN license. Ability to medically review; Assigns case reviews by identifying the issues for review and the...

Registered Nurse Manager - Case Management

Stamford Hospital - 66 reviews - Stamford, CT
$5,000 - $10,000 a month
Minimum of 1 year of case management, utilization review, or discharge planning experience preferred. Qualified Case Managers will possess a current CT RN...

Telephonic Case Manager RN - Telecommute - Blue Ash, OH

UnitedHealth Group - 3,953 reviews - Cincinnati, OH 45208 (Hyde Park area)
Experience in utilization review, concurrent review and / or risk management. Current, unrestricted RN license in the State of Ohio....

Medical Review Specialist (Nurse)

Blue Cross and Blue Shield of Nebraska (BCBSNE) - 3,261 reviews - Omaha, NE
Determine member eligibility prior to medical review. Perform accurate and timely medical review of preauthorizations....

Nurse IV

Health & Human Services Comm - 5 reviews - Fort Worth, TX  +3 locations
$4,599 - $7,533 a month
Conducts utilization reviews for Medicaid recipients in Medicaid approved hospitals to determine accuracy of the diagnosis and procedure coding, to ensure...

Utilization Manager, Utilization Management, 1700 South Lama...

Austin Travis County Integral Care - 22 reviews - Austin, TX
$5,063 a month
The primary functions of this position are utilization management, conducting utilization reviews, granting authorizations, and monitoring compliance with and...
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UM Nurse Consultant

Aetna - 1,627 reviews - Phoenix, AZ  +8 locations
Click here to review the benefits associated with this position. Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit...

RN Medical Reviewer II

BlueCross BlueShield of South Carolina - 3,261 reviews - Columbia, SC  +4 locations
Medicare and utilization review experience. Provides support and review of medical claims and utilization practices....

Concurrent Review Nurse I - Lake Charles (remote position)

LA Healthcare Connections - Lake Charles, LA
Current state’s RN license. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors...


State of Hawaii - 54 reviews - Hawaii
$8,013 - $9,951 a month
Staff Development, Utilization Management, Quality Improvement, Infection Control or Risk Management. CLICK HERE for further information about Equal Employment...
Case Manager - Social Worker or RN
Hill Country Memorial - 4 reviews - Fredericksburg, TX
Prefer knowledge/ experience in case management and utilization review. Perform utilization review function such as review of patient status and work closely...
Case Manager Registered Nurse (RN) - Full Time (Days)
Performs admission and concurrent review for all payers and maintains legible documentation as directed by the Utilization Management Plan....
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Company with RN Utilization Review jobs
HealthCare Partners is a division of DaVita HealthCare Partners Inc., a Fortune 500® company that provides a variety of health care services