Utilization Review Nurse
Speros
Moffitt Cancer Center in Tampa, FL seeks an Utilization Review Nurse to perform initial, concurrent, and retrospective reviews ensuring medical necessity and appropriate care levels. You will collaborate with case management, physician advisers, providers, and payers to support appropriate resource use and effective appeals. Minimum education includes an Associate's Degree in Nursing with RN licensure; a Bachelor's in Nursing is preferred. #J-18808-Ljbffr
- ...City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary...SuggestedTemporary workRemote workShift work
$30 - $38 per hour
...Ready to turn clinical expertise into life-changing decisions, one review at a time? Why This Role Matters Every determination you make... ...license accepted where applicable) Graduate of an accredited nursing program (ADN or diploma required; BSN preferred) 1-2+ years of...SuggestedHourly payImmediate startMonday to FridayFlexible hours$77.08k - $119.47k
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted on: Posted Todayjob requisition... ...and health care team.**Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate's degree required...SuggestedShift work$90k - $107k
...Mass General Brigham Health Plan Holding Company, Inc. is seeking a Remote UM Nurse to support network adequacy review and authorization activities for members in ACO, HMO, and EPO products. The role requires clinical knowledge to review prior authorization requests,...SuggestedRemote work- ...UnitedHealthcare is seeking a Preservice Review RN to review provider requests for medical necessity and benefit level. The role supports self-funded lines and may precept new staff. Availability is required Monday–Friday 8:00 am–5:00 pm PST, with the option to work remotely...SuggestedRemote workMonday to Friday
- ## Utilization Review NurseApplyremote type: Hybridlocations: 1301 6th Ave W - BRADENTON, FLposted on: Posted Todayjob requisition id: JR1141... ...possible.**Job summary:**Acrisure is seeking a **Utilization Review Nurse, LPN** to evaluate treatment requests and help ensure injured...Work at officeImmediate startRemote workFlexible hours2 days per week
$88.85k
...income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically...Full time- ...Work Shift The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to... ...patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care...Work at officeShift work
$66.83k - $111.38k
...8am to 5pm EST, M-F. Weekend and holiday coverage required. Nurses participate in a self‑scheduling process and are expected to... ...state), West Virginia, Wisconsin, Wyoming. Job Responsibilities Utilization Review Nurse is responsible for utilizing management services within...Permanent employmentFull timeTemporary workRemote workShift workDay shift- SUMMARY The Authorization Nurse will oversee the processing of assigned authorizations for participant care, supplies, and other related... ...' experience in a managed care environment, preferably in a utilization related role. Must have one year of experience with a frail,...Work at office
$25 - $31 per hour
...lands on your desk is a moment where your review decides what happens next for a real... ...accuracy and pace are what keep the entire utilization review process trustworthy. Schedule:... ...mental health, substance abuse, skilled nursing, and rehab stays, for medical appropriateness...Hourly payMonday to Friday- Centene Corporation is seeking a licensed nurse (LPN or RN) in Oklahoma for a remote role focused on authorization reviews and utilization management. Responsibilities include assessing medical necessity, coordinating with healthcare providers, and ensuring timely care...Remote job
- WNS, a Capgemini subsidiary, seeks a licensed RN/LPN for utilization review in a remote U.S.-based role. You will determine medical necessity, support case management, and ensure HIPAA compliance while collaborating with providers and clients. Regular CST schedule applies...Remote job
- ...Current BLS Certification (AHA/ARC) Current ACLS Certification (AHA/ARC) Preferred Qualifications: Progressive Care Certified Nurse (PCCN) Certification NIHSS Certification Other certifications and licenses may be required for this position Summary: A...Temporary work
- ...are 14 weeks with the option to extend or go to another Sanford site! Job Summary The Registered Nurse (RN) is responsible for utilizing the nursing process (assessment, diagnosis, outcomes/planning, implementation and evaluation) to provide individualized...Weekly payFull timePart timeWork from homeRotating shift
$85.28k - $87.36k
...Registered Nurse (RN) Pediatric Home Health A Nursing Role Built for Focused, One-on-One Care We are seeking Registered Nurses (RNs) with experience caring for tracheostomy and ventilator-dependent patients in a home health setting. At Care Options for Kids, pediatric...Weekly payPart timeLocal areaFlexible hoursShift work$85.28k - $89.44k
...Registered Nurse (RN) Pediatric Home Health Sign-On Bonus Opportunity! Eligible candidates may qualify for a $500sign-on bonus* as part of their total compensation package. Bonus eligibility and payout structure will be discussed early in the interview process....Weekly payFull timeLocal areaRelocation packageFlexible hoursShift work$50 per hour
...Services, Inc: Careline provides temporary staffing services to healthcare facilities, particularly in the professions of Registered Nurses, Licensed Practical Nurses, Physical Therapists, Certified Nursing Aids and allied medical professions.Careline also assists in the...Hourly payTemporary workPart timeImmediate startShift workNight shiftWeekend work$27.36 per hour
...and create relationships that motivate us all every day. Join us today, and experience a career well lived. Licensed Practical Nurse $27.36 per hour This is a fantastic role to continue your nursing career path and work within a setting that offers variety...Hourly payFull time- ...DESCRIPTION Brooklyn Center is hiring a Registered Nurse (RN) in Brooklyn, NY. We now offer Daily Pay through a trusted third... ...policies & protocols Resolves Resident problems &needs by utilizing multidisciplinary team strategies Assures quality of care by...Daily paidTemporary work
- ...Boro Park Center is hiring a Registered Nurse (RN) in Brooklyn, NY. DUTIES: As a Registered Nurse (RN), Provide advice & support... ...policies & protocols Resolves Resident problems &needs by utilizing multidisciplinary team strategies Assures quality of care by...
$66.56k - $70.72k
...Licensed Practical Nurse (LPN) Pediatric Home Health A Nursing Role Built for Focused, One-on-One Care in New Jersey At Care Options for Kids, pediatric home health nursing is intentionally different. Instead of juggling multiple patients and constant interruptions...Weekly payPart timeLocal areaFlexible hoursShift work$70.72k - $72.8k
...Licensed Practical Nurse (LPN) Pediatric Home Health A Nursing Role Built for Focused, One-on-One Care in New Jersey At Care Options for Kids, pediatric home health nursing is intentionally different. Instead of juggling multiple patients and constant interruptions...Weekly payPart timeLocal areaRelocation packageFlexible hoursShift work$118.94k - $152.72k
...them out of the crowded hospital system so they can heal and age where they are most comfortable- in their homes and community. Our nurses provide the Future of Care by meeting patients where they are. We design and deliver individualized care plans and exceptional...Relocation packageFlexible hours- ...Responsibilities Stepdown Nurses (RN) provide patient care in transitional units where patients are too sick for the med-surg floor but not sick enough for intensive care. Stepdown RNs job responsibilities include, but are not limited to: Evaluate and monitor...Local areaShift workNight shift
- ...Responsibilities Neuro Nurses (RN) treat patients with neurological injuries and disorders, including head and spinal trauma from accidents, or illnesses such as Parkinson's disease, Alzheimer's, epilepsy, and multiple sclerosis. Neuro RN job responsibilities include...Local areaShift workNight shift
- Responsibilities Emergency Room RNs (ER RNs) record present symptomology, as well as collect a thorough patient history. The ER RN assesses, plans, implements, and evaluates patient care plans in coordination with other healthcare team members. ER RN job responsibilities...Local areaShift workNight shift
- Responsibilities Emergency Room RNs (ER RNs) record present symptomology, as well as collect a thorough patient history. The ER RN assesses, plans, implements, and evaluates patient care plans in coordination with other healthcare team members. ER RN job responsibilities...Local areaShift workNight shift
- ...most comfortable- in their homes and community. Our LPNs provide one-on-one, individualized care with the direction of our Registered Nurses, meeting patients where they are and delivering exceptional clinical outcomes to our neighbors most in need. Interested in...Full timeWork experience placementRelocation packageFlexible hours
$35.35 - $38.16 per hour
...LPN - Licensed Practical Nurse Come join us at Ozanam Hall Nursing Home of Queens! A Faith-Based, Nonprofit, Short-Term Rehabilitation... ...to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor....Hourly payFull timeTemporary workPart timeImmediate startNight shiftDay shiftAfternoon shift
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