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Rn utilization review jobs

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Tower Health

 ...and services for an assigned unit-based patient population. The Case Managerpromotes quality of care, supports effective resource utilization, and facilitates the patient’s progression of care to proactively plan for the patient’s safe andtimely discharge to the most... 
2 days ago
Pottstown, PA

Integrated Resources, Inc

 ...importance and as applicable to assigned role) Provide a range of utilization management activities for members in an inpatient setting. *...  ...Determines reimbursement methodology and schedules concurrent review appropriately * Reviews inpatient admissions, telephonically... 
16 days ago
Watertown, MA

Presbyterian Healthcare Services

 ...of effective and efficient patient care. The role integrates utilization management, care coordination, and transition planning functions...  ...Science in nursing (MSN) degree plus five years utilization review or case management experience or Registered Nurse with Bachelors... 
7 days ago
Albuquerque, NM

A-Line Staffing Solutions

 ...Job Description RN Registered Nurse / Utilization Review / Prior Authorization – New Albany, OH Looking for an RN to perform telephonic concurrent review for acute care , LTAC, and skilled nursing facilities. Must report to the office in New Albany, OH. RN Utilization... 
4 days ago
New Albany, OH

Parkridge Medical Center

 ...time P arkridge Medical Center Chattanooga, TN Utilization Reviewer - Case Management Shift Details: Full Time No Weekends...  ...status, or disability status. Qualifications ~ RN, Bachelor's or Masters Degree in Behavioral Health related field... 
1 day ago
Chattanooga, TN

T7C Consulting

 ...looking to expand your nursing career into case management and utilization review? If you have an interest in technology and a passion for case...  ...Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral... 
6 days ago
Westborough, MA

Healthcare Support

$34 per hour
 ...Intro: Are you an experienced Utilization Review RN looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the... 
12 days ago
New Albany, OH

Accede Solutions Inc

 ...Description: This position is responsible for conducting utilization review for medical services utilizing evidence based guidelines, review... need to make the cut: ~ Requires active, unrestricted RN license. ~3+ of recent experience working as an RN in a... 
3 days ago
West Des Moines, IA

T7C Consulting

 ...looking to expand your nursing career into case management and utilization review? If you have an interest in technology and a passion for case...  ...Qualifications and Requirements: 1. Active, unrestricted RN (BSN preferred) license in Texas 2. Utilization knowledge on... 
19 days ago
Los Angeles, CA

w3r Consulting

 ...Job Description Registered Nurse-Review Analyst: Responsible for the approval or rejection of claims, admissions approvals...  ...Clinical experience in ICU, ER or Med Surg preferred. Prefer Utilization Management experience. Company Description Established... 
4 days ago
Detroit, MI

Aspire Health Partners

 ...As a Utilization Review Specialist I at Aspire Health Partners, your job purpose will be to provide a multitude of duties in order to coordinate...  ...~ Bachelor Degree in a healthcare field, Florida Licensed RN or LPN preferred Other Qualifications: Experience with insurance... 
2 days ago
Sanford, FL

Fairfax Behavioral Health

 ...and healing. We currently have an available opportunity for a Utilization Review Coordinator in our Kirkland, Washington hospital. POSITION...  ...license preferred. Minimum qualification is Washington State RN license or licensed mental health clinician associate or Agency... 
3 days ago
Kirkland, WA


Medix is hiring for an Utilization Review Nurse with an elite Healthcare System. This is an exciting opportunity for you to focus on member needs...  ...system. BACKGROUND/EXPERIENCE - An active unrestricted RN License is required - 1-3 years of utilization review... 
6 days ago
Oak Brook, IL

UHS Corporate Office - Remote

 ...required This position supports the utilization management (UM) program by developing and...  ...documentation assessment, via medical record review and discussion with the physician as...  ...skills in a clinical setting required RN, required, with nursing experience in related... 
23 days ago
King of Prussia, PA

Change Healthcare

 ...all.Empower Your Future. Make a Difference.RN required3+ years of relevant...  ...initial, concurrent, and/or retrospective review of services that require prior authorization...  ...regulatory requirements (i.e. URAC), and state utilization review standards.* Ensures authorized services... 
3 days ago
Pensacola, FL

Medical Center Health System

 ...Position Summary: The Utilization Review Specialist conducts initial review on emergency room admissions to determine appropriate status placement according to MCG/InterQual guidelines and makes appropriate recommendations to designated physicians. Education... 
2 days ago
Odessa, TX

Hendrick Health System

 ...About Case Management JOB SUMMARY: The Utilization Review (UR) Nurse is a registered nurse who provides clinical review against nationally...  ...observation patients) regardless of payer type. The UR RN provides ongoing communication with health plan utilization... 
18 hours ago
Abilene, TX

Stonington Institute

 ...(UHS), has an immediate opening for a part-time (16 hrs/week) Utilization Review Specialist. UHS is a Fortune 500 corporation and in 2017 was recognized... Psychology or related Human Service Field, or licensed RN. Knowledge of Utilization Review Processes, insurance plans,... 
16 days ago
Groton, CT

Southwestern Health Resources

Southwestern Health Resources CIN seeks to hire an Utilization Management Reviewer RN to work Full Time. Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is a partner company of Texas Health. If hired for this position, you will become... 
16 days ago
Dallas, TX

Rochester General Health System

 ...Building LOCATION Rochester, New YorkSUMMARYAs a Registered Nurse - Utilization Review Specialist, your strong attention to detail, knowledge of...  ...:BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (... 
4 days ago
New York, NY