RN Utilization Review jobs

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Case Manager (licensed RN)
Blue Cross Blue Shield of Massachusetts 35 reviews - Quincy, MA
May include some Utilization Management functions. Uses clinical tools and information / data review to conduct comprehensive assessments of referred member's...
Sponsored by Blue Cross Blue Shield of Massachusetts
Registered Nurse
Visiting Nurse Association & Hospice of VT and NH - Brattleboro, VT
Appropriate treatment intervention, evaluation of outcomes, and utilization of services to ensure that patient care needs are met....
Sponsored by Visiting Nurse Association & Hospice of VT and NH
RN - Utilization Review Job
ProHealth Staffing. - Albuquerque, NM
Pro Health Staffing is looking for a Utilization Review RN who will be responsible for applying professional clinical skills and expertise in the utilization...
Sponsored by ProHealth Staffing.

RN Manager I Utilization Review

Anthem, Inc. 599 reviews - Tampa, FL - +1 location
Current unrestricted RN license in applicable state(s) required. Manages resource utilization to ensure appropriate delivery of care to members;...

RN Manager Utilization Mgmt

Anthem, Inc. 599 reviews - Hanover, MD
RN Manager Utilization Management. Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access,...

Acute Telephonic Utilization Review RN - Texas

Humana 954 reviews - San Antonio, TX
Active RN license. Conduct admission review, post-discharge calls and discharge planning. Humana is seeking a Clinical RN Advisor who will collaborate with...

Case Manager I (Prior Authorization)

Centene Corporation 214 reviews - City of Sunrise, FL - +2 locations
Utilization review, prior authorization, or managed care experience preferred. Current RN, LPN or LVN license required....

Nurse Medical Management l, II, or Sr

Anthem, Inc. 599 reviews - Louisville, KY
Prior managed care experience performing utilization review 2 - 3 years preferred. Current unrestricted RN license in Kentucky required....

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

Aetna 507 reviews - San Antonio, TX 78229 - +5 locations
RN with at least 3 years clinical experience. Previous managed care experience (utilization management, concurrent review) preferred....

Acute Telephonic Utilization Review RN - Texas

Humana Inc. 954 reviews - San Antonio, TX
Acute Utilization Review RN. Active RN license. Conduct admission review, post-discharge calls and discharge planning....

RN Care Manager, Utilization Management Nurse

CoreSource 24 reviews - Tucson, AZ - +1 location
Is currently seeking an RN Care Manager, Utilization Review. Perform medical claims review as required....

Utilization Reivew Nurse - Part Time

Health Choice 4 reviews - Phoenix, AZ
Conduct ongoing review for members in inpatient stay and utilize peer review, as necessary. The Part Time Utilization Review Nurse completes inpatient admission...

Call Center Nurse (RN PREFERRED) - Tampa, FL - #105467

Anthem, Inc. 599 reviews - Tampa, FL 33601
2 years of clinical or utilization review experience. Active RN license; Review of claim edits, pre-noted inpatient admissions or, episodic outpatient therapy...
Care Manager - Utilization Management RN
Highmark Health 7 reviews - Pittsburgh, PA
Current, valid, unrestricted RN license. 1 year of Utilization Management experience. Certification in Utilization Management or a related field....
Sponsored by Highmark Health
Utilization Review Specialist
St. Mary's Hospital Maryland - Leonardtown, MD
Current Maryland RN license or license eligible. Conducts admission, concurrent and retrospective reviews of patients in accordance with Hospital objectives and...
Sponsored by St. Mary's Hospital Maryland

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