utilization review rn jobs

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RN Utilization Management Exchange
Serve as consultant to LPNs to review and/or collaborate when review determination cannot be met based on initial clinical review....
Utilization Management Specialist, RN
Responsible for the review of clinical documentation in the Electronic Medical Record (EMR), comparing it to the nationally accepted and evidence-based criteria...
Utilization Review & Appeals RN
The Utilization Review & Appeals RN evaluates medical acuity to assess for appropriate level of care orders and documentation to facilitate insurance coverage....

PT- Case Management Nurse

McBee - Remote
Utilization Review experience and knowledge of InterQual criteria is required. Current RN license. Proficiency in medical record review....
Easily apply

Telephonic RN Weekend Utilization Management - Eastern Time...

Humana - 2,923 reviews - Charlotte, NC 28210 (Quail Hollow area)
Active RN license. Humana is seeking a Telephonic Utilization Management RN who will collaborate with other health care givers in reviewing actual and proposed...

National Nurse Reviewer

Auto Injury Solutions - 31 reviews - Remote
Perform utilization review in accordance with AIS structure. (1) Bill Review Solutions, which involve the review of first party medical claims, (2) Medical...

Nurse Case Manager (Remote)

Change Healthcare - 243 reviews - Pensacola, FL
2-3 years nurse case management or utilization review experience strongly preferred. Health Services position in an office-based Managed Services organization ...

Utilization Review Nurse RN

Novant Health - 477 reviews - Charlotte, NC
The Utilization Review RN serves as a leader resource in the utilization review process. The Utilization Review RN coordinates and conducts initial, concurrent,...

Community Health Nurse II (Health Care Facility Program), Gr...

Montgomery County Government - 133 reviews - Rockville, MD
$60,554 - $100,370 a year
Performs patient-centered reviews of Medicare and Medicaid recipients to assess the quality and appropriateness of care rendered in such facilities, and to...

Medical Review Nurse (TN) - Home-based - Nationwide Openings

Quality Health Strategies - 9 reviews - Nashville, TN  +1 location
At least one year healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, and CPT coding strongly preferred....
Easily apply

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....
Easily apply

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

Quality Health Strategies - 9 reviews - Atlanta, GA 30303 (Five Points area)
At least one year healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, and CPT coding strongly preferred....
Easily apply

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

Quality Health Strategies - 9 reviews - Denver, CO
At least one year healthcare experience that demonstrates expertise in conducting utilization reviews, ICD-9 coding, and CPT coding strongly preferred....
Easily apply
RN - Utilization Review Specialist - 100% FTE, Day
UW Health - 62 reviews - Madison, WI
Recent experience as an inpatient utilization review nurse or UM coordinator. The Utilization Review (UR) Specialist has well-developed knowledge and skills in...
RN Utilization Management Nurse
Serve as consultant to LPNs to review and/or collaborate when review determination cannot be met based on initial clinical review....

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