Utilization Review Nurse jobs in St. Louis, MO

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Utilization Review Nurse
Mercy - 228 reviews - Chesterfield, MO
The Utilization Review Nurse is responsible for the development, implementation, coordination, and follow-up of projects related to Mercy Care Management....
Relocate to FL - RN Utilization Review Specialist - $5k Sign...
FH Memorial Medical Center - 452 reviews - Chesterfield, MO 63006
The RN Clinical Case Manager/ Utilization Review Specialist will provide quality utilization case reviews and monitor hospital resource utilization processes...
Clinical Documentation Improvement Manager
BJC HealthCare - 145 reviews - St. Louis, MO
By the American Nurses Credentialing Center. Works collaboratively with the CDI team to facilitate documentation within the medical record that supports...

Remote Medicare Medical Review Registered Nurse (RN)

NCI Information Systems, Inc. - 183 reviews - St. Louis, MO
As the Medicare Medical Review Registered Nurse (RN), you will be primarily responsible for conducting clinical reviews of medical records during the course of...

Prior Authorization Nurse I

Home State Health Plan - 471 reviews - Chesterfield, MO
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...

Utilization Management Nurse Consultant (RN)- Registered Nur...

Aetna - 2,346 reviews - St. Louis, MO
The Registered Nurse (RN) - Utilization Management Nurse Consultant utilizes clinical skills to support the coordination, documentation and communication of...

Utilization/Case Manager

Mercy - 228 reviews - St. Louis, MO
Prepares and refers cases to Physician Advisor/Medical Director for review appropriately. Registered Nurse, Masters in Social Work or Masters in Counseling...

Case Manager II (Developmental Disabilities)

State of Missouri - 161 reviews - St. Louis, MO
$34,416 - $48,852 a year
Participates on the inter-disciplinary team to review each case. (Additional experience as a Registered Nurse may substitute on a year-for-year basis for a...

Nurse Case Manager - RN - UBC

Express Scripts - 2,256 reviews - St. Louis, MO 63134
Previous clinical criteria review experience preferred; The Nurse Clinician – RN is responsible for reviewing escalated clinical criteria reviews for providers,...

Outpatient Care Nurse

WellCare - 697 reviews - St. Louis, MO 63107 (Fairground Neighborhood area)
Required 2 years of experience in an acute clinical/surgical position(s), current experience in utilization management to include pre-authorization, utilization...

Utilization Review Nurse

Mercy - 228 reviews - Chesterfield, MO
The Utilization Review Nurse is responsible for the development, implementation, coordination, and follow-up of projects related to Mercy Care Management....

Utilization Review Coordinator

BJC HealthCare - 145 reviews - St. Louis, MO
Ensure appropriate utilization, which includes the evaluation of potential under and over-utilization according to patient's presentation and documentation....

ASSISTANT NURSE MANAGER

St. Luke's Hospital - Missouri - 4 reviews - Chesterfield, MO
Ensures proper utilization of supplies. Current licensure as a Registered Professional Nurse in the State of Missouri....
Certification Manager
The CM reviews. Licensed Registered Nurse in the State of Missouri. Certification Manager (CM) reviews for medical necessity utilizing evidence-based criteria....
Registered Nurse
Memorial Health System of Springfield, Illinois - Missouri
Participates in nurse peer review process. Clinical Nurse II:. 426, 433, 434, 474 CLINICAL STAFF NURSE LEVEL I-IV*....

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