Utilization Review Nurse jobs in Fort Lauderdale, FL

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Concurrent Review Nurse I
Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve...
Desired Experience: RN, Driver's License, Managed Care
Registered Nurse
Monte Nido & Affiliates - 11 reviews - South Miami, FL 33143
Nursing treatment planning, aftercare planning, administrative support, auditing of medical records, and ongoing participation as part of a...
Desired Experience: RN, Behavioral Health
Easily apply
•Utilization Review / Utilization Management Registered Nurs...
$33 an hour
Daily responsibilities as a Utilization Management / Utilization Review Nurse / Registered Nurse / RN / R.N. will include utilizing care guidelines to...
Desired Experience: RN, Managed Care
Easily apply
QA Registered Nurse
Southeast Homecare - 7 reviews - Miami, FL 33166
Responsible for prospective review of all coding of ICD9-CM scoring from the OASIS assessments, ensuring all services and documentation meet the...
Desired Experience: RN
Easily apply

Utilization Review Assistant Full Time Days

East Florida Division Shared Services - Fort Lauderdale, FL
The Utilization Review Assistant is responsible for providing administrative support to the Utilization Review team in the center, supports the smooth...

Registered Nurse (RN) Utilization Review Full Time Days

East Florida Division Shared Services - Fort Lauderdale, FL
The Utilization Review RN provides clinical information to patient Insurance Plans according to the terms of the contract, receive authorization...
Desired Experience: Microsoft Word, RN, Management Experience

Registered Nurse (RN) Supervisor Utilization Review

East Florida Division Shared Services - Fort Lauderdale, FL
This position will provide front-line support and supervision to the Utilization Review staff to focus on initial and continued stay utilization review and...
Desired Experience: RN

Concurrent Review Nurse I

Sunshine State Health Plan - 926 reviews - Sunrise, FL
Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve...
Desired Experience: RN, Driver's License, Managed Care

UM Nurse Consultant

Aetna - 3,260 reviews - Sunrise, FL
Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products...
Desired Experience: RN, Managed Care

Utilization Review Specialist

Advanced Recovery Systems - 26 reviews - Fort Lauderdale, FL
The Utilization Review Specialist (UR Specialist) is responsible for contacting external case managers/managed care organizations for pre-authorization and...
Desired Experience: RN, Social Work Certification, Managed Care

Pre-Authorization Nurse - Doral, FL

Humana - 4,173 reviews - Miami, FL
The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services...
Desired Experience: Microsoft Word, RN, LPN, Home Care

Pre-Authorization Nurse

Promise Healthcare - 30 reviews - Boca Raton, FL 33431
The Pre-Authorization Nurse is responsible for executing the registration functions such as insurance identification, verification and authorization in all...
Desired Experience: RN

Medical Review Nurse Auditor (RN + Certified Coder)

Performant Financial Corporation - 28 reviews - Sunrise, FL
The Medical Review Nurse Auditor - Inpatient (Nurse-Coder) objectively and accurately completes medical record reviews on assigned audits while meeting...
Desired Experience: RN, RHIT, Microsoft Office, CPT-4, Case Management, RHIA, Medical Coding Certification

Utilization Management Coordinator

INDEPENDENT LIVING SYSTEMS, LLC - 69 reviews - Miami, FL
Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, plan sponsors...
Desired Experience: NCQA Standards, Managed Care
Easily apply
Field Concurrent Review Nurse
$34 an hour
Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve...
Desired Experience: RN
Easily apply
Utilization Review RN (ID:1244)
He/She is a member of the multidisciplinary team, and monitors documentation in the medical record for accuracy and clinical compliance.
Desired Experience: RN, Managed Care
Easily apply