RN - Utilization Review
PSNYC , INC.
RN - Utilization ReviewThe Utilization Review RN is responsible for reviewing medical records to determine the appropriateness and medical necessity of hospital admissions and continued stays. The nurse collaborates with providers, insurance companies, and case managers to ensure compliance with coverage guidelines and supports optimal patient outcomes while managing healthcare costs.Required for Onboarding:Active RN LicenseBLS
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the RN - Utilization Review in New York, NY vacancy
$45 - $50 per hour
...for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby....SuggestedRemote jobHourly pay- Job Description Summary Your job is more than a job The RN Utilization Review position allows for necessary support for patient throughput, physician communication and meets payer requirements. These efforts will provide optimal workflow and successful patient outcomes....SuggestedShift workNight shiftWeekend work
- LCMC Health is seeking an RN Utilization Review nurse in Louisiana to support patient throughput and coordinate care with physicians and payers. You will perform care reviews, determine medical necessity, and document in EPIC, ensuring regulatory compliance and high-quality...SuggestedAfternoon shift
- LCMC Health in Louisiana seeks an RN for Utilization Review to support patient throughput, facilitate physician communication, and determine medical necessity in alignment with CMS and payer guidelines. You will document workflows in EPIC, identify barriers in treatment...SuggestedShift workNight shiftWeekend work
$30 - $38 per hour
A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...SuggestedRemote jobHourly payPart time$65.48k - $96.89k
R1 RCM Inc. is seeking an RN Utilization Review Author to join the Physician Advisory Team, performing first-level admission and continued stay reviews using InterQual and MCG to determine appropriate care levels. The role requires an active RN license, a Bachelor’s Degree...Flexible hoursAfternoon shift- Devoted Health is seeking a Clinical Guide on our Outpatient Utilization Management team to review outpatient authorization requests using evidence-based criteria and CMS requirements. You will help ensure appropriate care settings and support members navigating the healthcare...Remote jobFull time
- A healthcare staffing agency is seeking a Utilization Management RN to work remotely from PA, DE, or NJ. The role involves assessing clinical information, determining medical necessity for services, and collaborating with providers. Candidates should have at least three...Remote jobFlexible hoursWeekend workDay shift
- University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and appropriate care. You...Remote jobFull time
$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $1...- Healthfirst in New Jersey is seeking a Medical Peer Reviewer to support the CMO Administration by assessing requests for authorization... ...per week and paid time off; the team collaborates across Utilization Management, Care Management, and medical departments. #J-1880...
$34 - $40 per hour
...learn more. Base pay range $34.00/hr - $40.00/hr Remote (Compact Licensure Required) - Open to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-based health services. In this...Full timeRemote workMedix
New York, NY5 days ago- ...A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with...Remote work
Medix
New York, NY5 days ago $35 - $43 per hour
...$35.00/hr - $43.00/hr Job Title Clinical Review Nurse – Concurrent Review Location: Remote... ...– must reside in CA or hold an active CA RN license) Duration: 12 months (with... ...Review Nurse – Concurrent Review will perform utilization management functions to ensure members receive...Remote workIMCS Group
New York, NY1 day ago- Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant documentation and communications with...Remote jobWork at office
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside in PA, DE... ...services. You’ll use advanced clinical judgment to review medical records, validate care plans, and authorize services...Immediate startRemote workWeekend workDay shift
$65 per hour
Job Title: Registered Nurse (RN) - Case Management Location: New York, NY 10037 Start... ...manage resources, and ensure appropriate utilization of healthcare services while maintaining... ...discharge planning. Conduct utilization review to ensure appropriate level of care and...Hourly payWeekly payLocal areaShift work- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote jobContract work
- Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract... ...Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This...Full timeContract workRemote work
$35 - $45 per hour
...message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources... ...Graduate of an accredited professional nursing program (RN, LPN, or LVN). Minimum of two years of general nursing experience...Contract workRemote workWeekend work- ...Job Description Job Description Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site.The Utilization Review Physician is the lead clinician for the health...Remote work
Vivo HealthStaff
New York, NY14 days ago - Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We are leaders in assisting front-line...Full timeContract workRemote work
- ...admission certification, continued stay review, discharge planning, outpatient, and ancillary... ...., following established MetroPlusHealth Utilization Management policies, procedures, and... ...practice as a Registered Professional Nurse (RN), License Practical Nurse (LPN), or...Shift work
- A healthcare solutions company is seeking a Utilization Management Nurse Reviewer to assess the appropriateness of medical services and collaborate with healthcare professionals. This role requires a Licensed Practical/Vocational Nurse with clinical experience and skills...
$20 - $30 per hour
A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...$219k - $286.9k
...Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the...Full timeLocal areaRemote workWork from homeHome officeWeekend workOscar Health
New York, NY1 day ago- A recruitment agency is seeking a Pre-Certification RN to evaluate clinical conditions and determine medical necessity for services. This remote position requires an active RN license in PA or a Compact license, along with a minimum of 3 years of acute care clinical experience...Remote job
- NeueHealth is seeking a Utilization Management Prior Authorization Nurse to ensure appropriate... ...with Medical Directors and clinicians to review authorizations for treatments, medications... .... Qualified candidates hold a California RN license, with 2+ years in utilization...
- CVS Health is seeking a Utilization Management Nurse Consultant to coordinate, document and communicate all aspects of the utilization/benefit... ..., while adhering to federal and state turnaround times and reviewing clinical records. This full-time, remote role requires Monday-...Remote jobFull timeMonday to Friday
- ...Physician Reviewer Opportunity Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel... ...license and Workers' Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering...Price workExtra incomeFor contractorsRemote workFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN - Utilization Review. Be the first to apply!
