Utilization Review Nurse jobs

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Nurse Medical Mgmt I- Outpatient Utilization Management 1083...
Anthem, Inc. - 1,538 reviews - Des Moines, IA
Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure...
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Nurse Medical Mgmt I- Utilization Management Inpatient Revie...
Anthem, Inc. - 1,538 reviews - Des Moines, IA
Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure...
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Utilization Review Nurse
Mercy - 132 reviews - Chesterfield, MO
Role of Utilization Review Nurses. Utilization Review Nurses coordinate and perform precertification, out of network precertification, inpatient concurrent...
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Prior Authorization Nurse (FT, Days)

El Paso Children's Hospital - 15 reviews - El Paso, TX 79905 (Central area)
Three years of clinical nurse experience as Registered Nurse required. The Prior Authorization Nurse’s primary responsibilities are to perform the review...

RN/LPN - Work from Home!

eviCore healthcare - Colorado Springs, CO 80907 (Northeast Colorado Springs area)
An understanding of Utilization Review is highly preferred. Must be a Registered Professional Nurse or Licensed Practical Nurse....

Clinical Quality Reviewer - Remote

HMS - 453 reviews - Las Vegas, NV
This person is responsible for complex quality reviews to determine if decision by review staff matches medical records and approved review methodologies....

Nurse Medical Mgmt I/II-Northern CA - 117186SY

Anthem, Inc. - 1,538 reviews - Sacramento, CA
Knowledge of the Continued stay review process is required. RN Nurse Medical Management – Telecommute – Northern California....

Utilization Review Nurse

Berkley Medical Management Solutions - San Diego, CA
To perform the utilization review services of pre-certification, concurrent review, retrospective review, nurse research, and short-term disability review as...

Utilization Management Representative I - San Diego, CA - 11...

Anthem, Inc. - 1,538 reviews - San Diego, CA  +2 locations
Refers cases requiring clinical review to a Nurse reviewer. Utilization Management Representative I:. Responsible for coordinating cases for precertification...

Medical/UR Services Coordinator (Admin/Clerical Role)

York Risk Services Group Inc. - Austin, TX
Knowledge of Utilization Review Regulations. Document various systems of work completed and outcomes of the reviews....

Medical/UR Services Coordinator

York Risk Services Group Inc. - Orange, CA
Knowledge of Utilization Review Regulations. Document various systems of work completed and outcomes of the reviews....

LA MCD Concurrent Review Consultant (RN)

Aetna - 1,539 reviews - Baton Rouge, LA 70816
Managed care/utilization review experience strongly preferred. Functional - Clinical / Medical/Concurrent review / discharge planning/4-6 Years....

RN Utilization Review

Medix - 48 reviews - Wilmington, DE  +2 locations
Utilization Review Nurse is responsible for conducting admission and concurrent utilization review for members....
Care Nurse Advisor (Call Center) - Sign-on Bonus!
Patient First - 101 reviews - Glen Allen, VA
Utilization review and call center experience a plus;Computer skills and experience with Microsoft Word and Excel (required);...
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Utilization Management Nurse
Assists in the coordination of patient/department activities ensuring efficient utilization of multidisciplinary resources....
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Company with Utilization Review Nurse jobs
Anthem, Inc. is working to transform health care with trusted and caring solutions.