Utilization Review RN jobs

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RN Case Manager
Minimum Associate degree, RN diploma, or Bachelors (or higher) degree required. Experience in case management, home health, critical care, medical/surgical,...
RN Care Manager
York Hospital - 28 reviews - York, ME 03909
2 or more years of Utilization Review experience. An active RN License. Performs on-site and/or telephonic concurrent review of acute services, as well as...
Case Manager/Utilization Review Registered Nurse (RN)
Piedmont Healthcare - 181 reviews - Atlanta, GA 30363
Coordinates progression of care as well as resource utilization across the continuum. Evaluating medical necessity and appropriateness of scheduled and direct...

Telephonic Utilization Management RN - Daytona Beach

Humana - 2,252 reviews - Daytona Beach, FL 32114
Conduct admission review, post-discharge calls and discharge planning. Humana is seeking a Clinical RN Advisor who will collaborate with other health care...

Contingent Care Utilization Review Coordinator RN

Kaiser Permanente - 4,124 reviews - Cupertino, CA
Reviews utilization patterns, identifies trends and problems areas for special studies. Conducts utilization review for in-house patients and/or those members...

Nurse Medical Mgmt I/II/Sr - Telecommute (State of CA) - 125...

Anthem, Inc. - 1,871 reviews - California
Previous Utilization Management experience is strongly desired. Conducts pre-certification, continued stay review, care coordination and discharge planning for...

UM Nurse Consultant

Aetna - 1,911 reviews - Chantilly, VA  +9 locations
Requires an RN with unrestricted active license. Click here to review the benefits associated with this position....

Utilization Management (UM) Nurse Associate

Aetna - 1,911 reviews - Blue Bell, PA 19422
LPN or RN (RN Preferred). Licensed Nurse, LPN or RN (RN is preferred). Click here to review the benefits associated with this position....


Inova Fairfax Hospital - 425 reviews - Fairfax, VA
Prior utilization review or case management experience required. Virginia RN License and Graduate of National League of Nursing accredited school of nursing:....

RN Medical Reviewer III

CGS Administrators - 17 reviews - Chattanooga, TN  +6 locations
Provides support and review of medical claims and utilization practices. Two years of clinical experience, plus one year of administrative/medical review...

Utilization Review Specialist (RN) Job

HealthPartners - 157 reviews - Bloomington, MN
We currently have an exciting new opportunity for a Utilization Review Specialist (RN). Responsible for prospective, concurrent review and retrospective review...

RN Utilization Review - Utilization Management

Penn State Milton S. Hershey Medical Center - 18 reviews - Reading, PA
Minimum of two years acute hospital experience in nursing and/or utilization review or management. RN licensure in the state of practice....

Care Review Clinician, Inpatient Review (RN) - Remote in WA

Molina Healthcare - 327 reviews - Vancouver, WA  +2 locations
Utilization Management Certification (CPHM). May also perform prior authorization reviews and/or related duties as needed....
Registered Nurse - ER 10am-10pm (SIGN-ON / Relocation - ask...
The RN is responsible for directing, monitoring and evaluating the care delegated to non-licensed personnel....
Sponsored by HCA Inc
Nurse-Utilization Review
RN - Registered Nurse. The utilization review nurse will monitor the patient's progression in their plan of care and perform continue stay reviews to ensure...

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