Utilization Review Nurse jobs in San Antonio, TX

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Registered Nurse (RN) Appeals/Denials Spec II
Molina Healthcare 190 reviews - San Antonio, TX
Active, unrestricted State Licensed Register Nurse, Vocational Nurse or Licensed Practical Nurse in good standing....
Disease Management Registered Nurse (RN)
The Arora Group 6 reviews - San Antonio, TX
Understand DM principles to include the use of CPGs, nurse-run clinics, concurrent and retrospective record reviews and Utilization Management/Utilization...
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Transplant Case Manager, RN - Multiple Locations - Telecommu...
UnitedHealth Group 2,436 reviews - San Antonio, TX
Experience in utilization and/or concurrent review. Registered Nurse, RN,BSN, Case Manager, Transplant, CCM, Utilization Review, Work from Home, Remote,...

Utilization Mgmt Nurse RN- $3000 Sign on Bonus

WellMed Medical Mgmt, Inc - San Antonio, TX
May provide guidance and coaching to other utilization review nurses and participate in the orientation of newly hired utilization nurses....

Utilization Management Nurse Consultant

Aetna 624 reviews - San Antonio, TX 78229
Positions include Precertification, Concurrent Review, and Retro Review. UM Nurse Consultants require:. Precertification, pre determination, concurrent review,...

UM Nurse Consultant

Aetna 624 reviews - San Antonio, TX 78218 (Camelot area)
Utilization Management experience preferred. Click here to review the benefits associated with this position....

Concurrent Review Nurse I

Centene Corporation 271 reviews - San Antonio, TX 78230 (Vance Jackson area)
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...

Field Services Coordinator-Field Case Management - RN

WellCare 151 reviews - San Antonio, TX 78216
Promotes effective utilization and monitors health care resources. Prior utilization management experience preferred in some geographic regions....

Nurse IV

Health & Human Services Comm - San Antonio, TX
$4,599 - $7,533 a month
The Nurse Reviewer plans and conducts reviews and investigations, prepares reports and makes appropriate notification for the Office of Inspector Utilization...

Medical Review Nurse - San Antonio

Quality Health Strategies - San Antonio, TX
At least one year healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, CPT coding, and knowledge of Medicare and...


The Judge Group 62 reviews - San Antonio, TX
UTILIZATION REVIEW AND REGISTERED NURSE:. Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according...
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Case Manager/CDI Specialist

Foundation Surgery Affiliates 3 reviews - San Antonio, TX
Works proactively to maximize the effectiveness of resource utilization. Applies review criteria to determine medical necessity for admission and continued stay...

Utilization Management Coordinator

WellMed Medical Mgmt, Inc - San Antonio, TX
Prepares administrative files for Medical Directors, UM Nurses and Case Managers. Coordinates initial screening for UM claim reviews through claim queue....
Registered Nurse (RN) Supervisor, Utilization Management II
Molina Healthcare 190 reviews - San Antonio, TX
Completes quality audit reviews for all clinical / non-clinical staff. Collates and reports on Care Access and Monitoring statistics including plan utilization,...

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Company with Utilization Review Nurse jobs
The Arora Group is an award-winning healthcare staffing firm that provides world-class care to active duty heroes and their families.