utilization review rn jobs

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Case Manager RN FT - Come to the Florida Keys!
Case Management / Utilization Review. Case Manager RN FT - Come to the Florida Keys! Coordinates the overall interdisciplinary plan of care for a patient, from...
Sponsored by Community Health Systems
Baylor Scott & White Medical Center – White Rock - Dallas, TX
RN Case Manager -. RN Case Manager Responsibilities:. Participating in weekly Complex Case Review. This position integrates care coordination, utilization...
Sponsored by Tenet Healthcare
Performs Utilization Review for appropriateness of admission, intensity of service, and continued stay. Five years of recent experience in a clinical health...

Utilization Management Nurse

HealthCare Partners - 138 reviews - Orlando, FL 32803 (Colonicaltown North area)
We are seeking a Utilization Review Nurse- Affiliates to. Conducts concurrent reviews and. Supplemented with medical record reviews....

Utilization Management Specialist

Commonwealth Care Alliance - 24 reviews - Massachusetts
Familiarity with utilization management review. Works closely with UM RN staff to escalate decisions that require clinical review....

NGS Nurse Reviewer Sr

Anthem, Inc. - 1,734 reviews - Syracuse, NY  +1 location
Act as Subject Matter Expert for pre-claim review process and Home Health Reviews. Coordinate pre-claim review process....

Utilization Review Case Manager

CorVel Corporation - 148 reviews - Cincinnati, OH
Strong cost containment background, such as utilization review or managed care preferred. Performs claim re-activation reviews....
Easily apply

Nurse Appeals - Inpatient Utilization Review - TN Medicaid -...

Anthem, Inc. - 1,734 reviews - Nashville, TN
Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure...

RN Auditor, Utilization Management Compliance

Evolent Health - 19 reviews - Indianapolis, IN  +1 location
Provides issue analysis and strategies for resolution and/or implementation and communicates to the Director of Utilization Management and Regulatory Compliance...


Healthsmart Preferred Care - Irving, TX  +1 location
Experience in Utilization Review, Case Management or Disease Management in an insurance setting preferred. Assist claims with quality reviews....

Utilization Review Case Manager CMC

The University of Texas Medical Branch - 382 reviews - Friendswood, TX
RN with three years of clinical RN experience. TDCJ, Case Management, Utilization Review, or Managed Care experience a plus....

Clinical Nurse Care Coordinator

EnvisionRx - 2 reviews - Twinsburg, OH
Is responsible for performing Comprehensive Medication Reviews (CMR) for members enrolled in the Medication Therapy Management (MTM) program and discussing...
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Utilization Management Nurse

Tampa General Hospital - 269 reviews - Tampa, FL
Florida state RN license; Under general supervision of the Utilization Review Manager, the Utilization Management Nurse will monitor and manage all inpatient...
Utilization Review Nurse
IntegraNet Health - Houston, TX 77018
RN. The Utilization Review Nurse works independently to plan, implement, and/or coordinate quality patient care and cost effective utilization of healthcare...
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Utilization Review Nurse PRN *RN Required
Utilization Review Certifcation designation. One year Utilization Review or Case Management experience....

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