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,...
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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...
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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...
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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....

UTILIZATION REVIEW COORDINATOR

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....
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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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