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Utilization Management (UM) Concurrent Review Consultant (VA...
Aetna - 2,218 reviews - Bristol, VA 24201
Managed care/utilization review experience strongly preferred. Functional - Clinical / Medical/Concurrent review / discharge planning/4-6 Years....
UTILIZATION REVIEW NURSE I
Registered Nurse or Licensed Vocational Nurse. The Utilization Review Nurse I also conducts initial and ongoing assessments, incorporates disease management...
Director of Utilization Review/Case Management - Beacon Heal...
Recommending knowledge and skill requirements for Utilization Review Nurses and Social Workers. Prepares and directs the Utilization Review Committees of each...

Remote Medical Review RN - Part B/DME - Casual Status

NCI Information Systems, Inc. - 5 reviews - Nashville, TN  +3 locations
Advanced Knowledge of utilization review/ quality assurance procedures. As a Remote Medical Review RN - Part B/DME - Casual Status ( Medical Reviewer III ), you...

Remote Nurse/Allied Health Professional Reviewer

Healthcare Quality Strategies, Inc. (HQSI) - East Brunswick, NJ
HQSI is recruiting experienced remote medical review auditors to conduct utilization review (UR) of appeals using electronic medical records on a per case basis...
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Medical Review Subject Matter Expert

Chickasaw Nation Industries - 11 reviews - Rockville, MD 20850
Extensive experience performing medical review and/or utilization/quality assurance reviews. Keeps Medical Review Manager informed of medical review status....

Onsite SNF Utilization Management RN-Asheville, NC

Humana - 2,650 reviews - Asheville, NC
Utilization review experience. Humana is seeking an Onsite Utilization Review nurse to focus on transition of care into skilled nursing facilities....

RN Acute Utilization Management – NC, SC, VA

Humana - 2,650 reviews - Charlotte, NC 28210 (Quail Hollow area)
Acute UM experience – medical necessity reviews. Active RN license in the state(s) in which the nurse is required to practice....

UM Nurse Consultant

Aetna - 2,218 reviews - Chantilly, VA  +14 locations
The Utilization Management Nurse Consultant is an integral member of the care management team. Nursing/Registered Nurse (RN) is desired....

Nurse - Appeals DRG Auditor - Remote

HMS - 538 reviews - Texas, AL
This person is responsible for complex quality reviews to determine if decision by review staff matches medical records and approved review methodologies....

Utilization Management Nurse Associate

Aetna - 2,218 reviews - Walnut Creek, CA  +3 locations
The UM Nurse Associate applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for...

Clinical Quality Reviewer - SNF Utilization Review - Remote

HMS - 538 reviews - Texas, AL
Clinical Quality Reviewer - SNF Utilization Review - Remote. This person is responsible for complex quality reviews to determine if decision by review staff...

Clinical Quality Reviewer - Utilization Review - Remote

HMS - 538 reviews - Texas, AL
Clinical Quality Reviewer - Utilization Review - Remote. This person is responsible for complex quality reviews to determine if decision by review staff matches...
Utilization Management Nurse Consultant 42397BR
Aetna - 2,218 reviews - San Antonio, TX
UM Nurse Consultants require:. Precertification, pre determination, concurrent review, retro review, and discharge planning activities of the WEA members....
California Work-From-Home CONTRACT Utilization Review RN - M...
CareNational Healthcare Services (CNHS) - Mission Viejo, CA 92691
$37 an hour
The Utilization Review Nurse is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review....
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