Utilization Review RN jobs

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Utilization Review Nurse
Aspire Health Plan - Monterey, CA
RN. The Utilization Review Nurse will:. Active RN license. Participate in quality audits, chart audits, and reviews of medical records as needed for either...
Sponsored by Aspire Health Plan
Nurse Medical Management I or II - Las Vegas, NV - 110199
Anthem, Inc. 641 reviews - Las Vegas, NV
Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure...
Sponsored by Anthem, Inc.
Utilization Review Specialist - Fulltime - Highline Medical...
CHI Franciscan Health 11 reviews - Burien, WA
Performs medical necessity reviews of both inpatient and outpatient services using objective criteria in accordance with the CHI Franciscan Health utilization...
Sponsored by CHI Franciscan Health
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Utilization Management Manager, Nurse, BSN, 8am-5pm (Days, R...

Penn State Hershey Medical Center 33 reviews - Hershey, PA
Career, Employment, Jobs, Opening, Shift, Schedule, Staff, Department, Unit, Office, Occupation, Compensation, Salary, Benefits, Description, Days, Evenings,...

Nurse Audit Sr - Telecommute - 110188

Anthem, Inc. 641 reviews - Indianapolis, IN
The incumbent is responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers...

Registered Nurse (RN) - Utilization Management

Aetna 573 reviews - Champaign, IL  +1 location
Requires an RN with unrestricted active license. 1+ year of Utilization Management (UM) is preferred. Click here to review the benefits associated with this...

Healthcare Utilization Review Coordinator II - Nursing

University of Illinois Hospital & Health Sciences... 5 reviews - Chicago, IL
Knowledge and/or experience of utilization review procedures and techniques (e.g. Provides utilization management functions for patients:....

RN / Utilization Review - FT (w/ $3,000 sign on bonus)

Oswego Health - Oswego, NY
RN / Utilization Review / Behavioral Health. Responsible for coordinating utilization review functions including the coordination of the Utilization Review...

Precert Nurse Consultant

BCBSKS - Wichita, KS
$52,532 a year
Provide nursing expertise for precertification and alternative care review activity to medical review staff. Independently conduct audits, medical record review...

Care Review Clinician III-UR/RN-(REMOTE-Evenings/Weekends)

Molina Healthcare 166 reviews - Long Beach, CA
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review....


Presbyterian Healthcare Services 56 reviews - Albuquerque, NM
Coordinates and acts as a resource for policies, procedures, and operational changes related to utilization review, denials, and timeliness standards....

Utilization Review Case Manager (RN) Case Management HRMC FT...

Holmes Regional Medical Center 46 reviews - Melbourne, FL
Utilization Review Case Manager / Registered Nurse (RN). Prior Case Management / Utilization Review experience strongly preferred....

Care Management Supervisor - RN or MSW

Community Health Alliance - Reno, NV
RN or MSW. RN or MSW level credential. Monitors and review pertaining daily activities. Constantly alert for ways to improve customer service, improve patient...
Easily apply
Case Manager/Utilization Review RN - FT - $5K Sign On Bonus
Piedmont Healthcare 130 reviews - Atlanta, GA
Follow Medicare guidelines regarding utilization review (Condition Code 44, 2MN Rule, etc) 6. Perform admission, concurrent, and retrospective reviews on all...
Sponsored by Piedmont
Utilization Review RN Evening $5K Sign-On Bonus
Piedmont Healthcare 130 reviews - Atlanta, GA
Three years Utilization or Case Management experience. The purpose of this position is to ensure that acute hospital admission have the appropriate level of...
Sponsored by Piedmont

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Company with Utilization Review RN jobs
Anthem, Inc. is one of the nation's leading health benefits companies with nearly 69 million people served by its affiliated companies.