Utilization Review Nurse $40,000 jobs

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Concurrent Review Nurse (Signing Bonus & Flex Scheduling)
Centene Corporation - 703 reviews - Tacoma, WA 98417
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
Concurrent Review Nurse I
Centene Corporation - 703 reviews - Chesterfield, MO 63005
Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case...
RN Nurse Medical Mgmt I (Utilization Management) - Remote -...
Utilization review experience required. The Nurse Med. This Nurse Medical Mgmt. Conducts pre-certification, continued stay review, care coordination, or...
Utilization Review Nurse
Maury Regional Health - Columbia, TN
_*Care Manager or Utilization Review experience preferred. The Utilization Review Nurses will review medical records of patients assigned and accurately apply...
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Utilization Review Nurse, Part-time, Remote

Advanced Health - Coos Bay, OR
Oregon Registered Nurse (RN) (Required). Send notifications for Third Party Review (TPR) or stop loss. Responsible for promoting quality and efficiency of...
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Clinical Review Nurse, Utilization Management

BlueCross BlueShield of Kansas City - 5,418 reviews - Kansas City, MO
1+ year(s) of utilization review, disease management, and/or case management experience. Conducts pre-service, concurrent and / or post-service utilization...

Utilization Review Clinician - Remote

Billing Solutions LLC - Phoenix, AZ 85015 (Alhambra area)   +1 location
The Utilization Review Clinician calls in clinical information to obtain insurance authorization for services offered by our clients to their patients....
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Clinical Consultant

Nuance - 282 reviews - Remote
Compliant Documentation Management Program (CDMP)® review of client clinical records for CDMP® assessments and continuing education/compliance reviews....

Clinical Care Reviewer Utilization Management

AmeriHealth Caritas - 313 reviews - Southfield, MI
Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient and outpatient services, working closely with members and...

RN DRG Validation - Remote

HMS Holdings - 29 reviews - Remote
This person is responsible for complex quality reviews to determine if decision by review staff matches medical records and approved review methodologies....
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Medical Review Nurse Auditor - Home-based - Seattle

Qlarant - Seattle, WA   +1 location
Qlarant has exciting opportunities for Medical Review Nurse Auditors to join our Cerritos, CA based Unified Program Integrity Contractors (UPIC) team....
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RN Utilization Clinical Review Specialist

HealthPartners - 255 reviews - Bloomington, MN
We have an exciting opportunity for a RN Utilization Clinical Review Specialist. Currently licensed Registered Nurse....

Nurse Case Manager Specialist-RN Quality Reviewer

Cigna - 2,900 reviews - United States
A minimum of 3 years of experience in a Nurse Case Manager or Utilization Review Nurse position with experience in quality strongly preferred....

Utilization Management Nurse

Wellmark - 19 reviews - Des Moines, IA
Additionally, this individual may complete clinical reviews and apply utilization review criteria for patient admissions and various levels of care, continued...
Utilization Review Nurse
Fidelis Care - 230 reviews - Getzville, NY 14068
Utilization Review Nurse. Utilization Management experience required. The Utilization Management (UM) Clinician performs clinical reviews to assess medical...
Utilization Review/Denial Specialist RN
CMS Regulations, Utilization Review criteria. Collect and trend Utilization Review data metrics. 3 -5 years of experience in acute care Utilization Review and...
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