Utilization Review RN jobs

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Utilization Review RN
Performs utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity....
Clinical Care Reviewer, Concurrent Review, Registered Nurse
Experience with Utilization Review and/or Prior Authorization. Current and unrestricted DE RN licensure. Refers cases to Medical Director for medical necessity...
PATIENT CARE NAVIGATOR RN
Inova Physician Services Corp - Falls Church, VA
RN VA License. Monitoring, self-management support, medication review and adjustment. Provides clinical advice and guidance on appropriate utilization of...

Utilization Review HCP - Remote

EK Health Services Inc - Sacramento, CA
EK Health Services has built a reputation for offering superior, goal-oriented Workers' Compensation case management, utilization review, and bill review...

Utilization Review Spclst. - Case Management - Full Time - D...

Kettering Health Network - 120 reviews - Miamisburg, OH 45342
Responsible for completing clinical review on all assigned patients and communicates these reviews to payers. Join our Utilization Management team!...

Health Care Advocate - RN (Remote)

Nova Healthcare Administrators, Inc. - Denver, CO
Clinical RN experience in a med/surg or ambulatory care:. Three (3) years of clinical RN experience in a med/surg or ambulatory care setting required....
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RN Case Manager- IN (Telecommute)

Tenet Healthcare - 1,436 reviews - Indiana
Pre-certification/Pre-notification Identifies and utilizes the applicable utilization review/management tools, while performing pre-certification/pre...

Medical Review Nurse (BOS) - Home-based - Nationwide Opening...

Quality Health Strategies - 9 reviews - Boston, MA
At least one year healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, and CPT coding strongly preferred....
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RN Case Manager- Telecommute- Tacoma Area WA

Tenet Healthcare - 1,436 reviews - Washington, DC
Pre-certification/Pre-notification Identifies and utilizes the applicable utilization review/management tools, while performing pre-certification/pre...

Continuum of Care Coordinator (RN or Social Worker)

Cedar Park Regional Medical Center - 32 reviews - Austin, TX   +1 location
Case Management / Utilization Review. The CCC will collaborate with Hospital Leadership and Case Managers to review trends in resource utilization....

Utilization Management Specialist (Part-Time-Flex Schedule)

Vanderbilt University Medical Center - 156 reviews - Nashville, TN 37232
Conduct initial admission based on utilization review medical necessity criteria. Utilization Specialist (UMS)....

Clinical Care Reviewer, RN Utilization Management - Off Hour...

AmeriHealth Caritas - 273 reviews - Charleston, SC   +2 locations
Managed care or utilization review experience preferred. Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient and...

Clinical Documentation Improvement Specialist - Chandler, AZ

UnitedHealth Group - 9,599 reviews - Chandler, AZ 85249   +5 locations
Provides expert level review of inpatient clinical records within 24-48 hours of admit; 5+ years acute care hospital clinical RN experience OR Foreign Medical...
RN Utilization REview - Per Diem
HonorHealth - 210 reviews - Phoenix, AZ
Reviews and monitors utilization of health care services with the goal of maintaining high quality cost-effective care....
Case Manager RN *Up to $7,500.00 signing bonus for eligible...
Case Management / Utilization Review. Our dedicated RN Case Managers address ongoing needs, maximize patient, family and provider satisfaction, optimize...