Utilization Review RN jobs

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Nurse Medical Management I or II - California - 96167SY
Anthem, Inc. 528 reviews - Los Angeles, CA
Current unrestricted California RN license required. Knowledge of the Continued stay review process and prior authorization preferred....
Sponsored by Anthem, Inc. - 6 days ago
RN Clinical Reviewer
Home Care by Black Stone 2 reviews - Columbus, OH
Reviews HIPPS/HRRG list weekly from billing and corrects. Access to utilization of public or private transportation system....
Sponsored by Home Care by Black Stone - 23 days ago
Utilization Review Coordinator (RN, LPN,LISW, LSW)
Promedica 26 reviews - Cincinnati, OH
RN, LPN, LSW, LISW. Minimum 2-3 years recent clinical, utilization review or case management experience in the mental health and/or chemical dependency field....
Sponsored by ProMedica - 30+ days ago

Regional Telephonic Case Manger RN

Kaiser Permanente 2,092 reviews - Oakland, CA
Current RN license. Kaiser Permanente conducts compensation reviews of positions on a routine basis. Develops & collects data, & trends relating to utilization...


Universal Health Services - Groton, CT - +1 location
Knowledge of Utilization Review processes, insurance plans, mental health and chemical dependency treatment....

Review Nurse (RN)

Alliant Health Solutions - Atlanta, GA - +1 location
Currently we are seeking 2 Review Nurses to be responsible for the complete medical review and appropriate processing of initial, second level and continued...
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Care Coordinator/Utilization Review Coordinator

Seton Medical Center 6 reviews - Daly City, CA
Department: Case Management Schedule: FULL TIME (80 hrs ppp; FTE =1.0) Shift: Day Shift Hours: 8:30-5:00pm; CB/ IND123 Contact Information: Tel: 213...

Resource Utilization Coordinator

St. Mary's Hospital and Medical Center - Grand Junction, CO
Review and collect data from medical records for quality monitoring, risk management, clinical documentation, and EMTALA reporting....

Registered Nurse (RN) - Utilization Management Nurse Consult...

Aetna 437 reviews - Harrisburg, PA 17102 - +15 locations
Conduct Utilization Review and Discharge Planning for members admitted to an acute facility. Click here to review the benefits associated with this position....

Registered Nurse (RN) - Utilization Managmenet Nurse Consult...

Aetna 437 reviews - Hartford, CT 06101 (North Meadows area)
Unrestricted RN license. Click here to review the benefits associated with this position. The Utilization Management Nurse Consultant is an integral member of...

RN Supervisor Utilization Review

AmeriHealth Caritas 42 reviews - Philadelphia, PA
2+ years experience supervising utilization review staff strongly preferred. Minimum 3 years of experience in managed care utilization review....

Coord, Utilization Mgmt

Saint Francis Health System 86 reviews - Tulsa, OK
Also participates in the Patient Care Committee for patient care reviews, and in Utilization Review Staff Committee, providing data and contributing to...

Pre-Service Review Nurse RN – Phoenix, AZ

UnitedHealth Group 1,823 reviews - Phoenix, AZ
RN, Registered Nurse, UR, UM, Pre-Authorization, Utilization Review, Utilization Management, Concurrent Review, Milliman, Interqual, Managed Care, Insurance,...
Special Needs Program Care Coordinator - RN
Peoples Health, Inc. 11 reviews - Metairie, LA
Participates in the coordination of the ICP review for ICT meetings. The SNP Care Coordinator - RN reviews Peoples Health databases to ensure that assessment(s)...
Sponsored by Peoples Health, Inc. - 30+ days ago
RN Clinical Quality/Compliance Admin Sr - Rancho Cordova, CA...
Anthem, Inc. 528 reviews - Rancho Cordova, CA
Certification in Medical Record Review is required. Quality Assurance, Utilization Management experience is a plus....
Sponsored by Anthem, Inc. - 5 days ago

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