RN Care Review Clinician: Utilization & Outcomes
Molina Healthcare of Illinois
Molina Healthcare is seeking an RN reviewer to support clinical member services review and assessment processes in Kentucky. You will verify medical necessity and alignment with guidelines, policies, and regulations to promote integrated care. The role requires hospital/acute care and prior authorization experience, strong communication, and collaboration with multidisciplinary teams to ensure quality, cost-effective member care across the continuum. #J-18808-Ljbffr Molina Healthcare
Vacancy posted 1 day ago
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$2,926 per week
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PSNYC , INC.
East Elmhurst, NY1 day ago $63.1k - $94.65k
.... *Must have current compact RN license, or be willing to obtain... ...* Schedule Information Our Utilization Review team provides coverage seven... ...proper utilization of health care resources and assists with identifying... ...all medical necessity review outcomes to in-house care management...SuggestedWork at officeFlexible hoursShift work- ## Job Title:RN - Utilization Review - PT## Job Summary:RN-Utilization Review is accountable to perform... ...criteria. Reports quality of care issues identified during the utilization... ...fiscal, clinical, and patient satisfaction outcomes.* Collects and analyzes variances from...SuggestedPart timeCasual workSeasonal workShift work
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...Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Astoria, New York. Job Description & Requirements... ...Utilization Review Exp About Cross Country Nurses You care for others — we're here to care for you. At Cross Country,...Shift workCross Country Nurses
Astoria, NY15 days ago- ## Registered Nurse (RN) Manager - Utilization Review - FT/Day - AugustaApply: Onsite: AU Medical Center, Inc... ...and guiding the quality of patient care delivered; assures staff and program... ...assure that optimal program quality outcomes and patient throughput are achieved....Full timeContract workLocal areaShift work
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## Utilization Review Registered NurseApply: Beth Israel Deaconess Medical Center... ..., the Utilization Review RN assists in determining the appropriate... .... Partners with the health care team to ensure reimbursement... ....6. Monitors effectiveness/outcomes of the utilization management...Hourly payFull timeLocal areaShift work$55 - $65 per hour
...Registered Nurse With Utilization Review Experience A healthcare organization is seeking a Registered Nurse with utilization review experience... ...in the Queens, NY area and requires an active New York State RN license. The ideal candidate will have experience reviewing...Hourly payContract workATRIA Consulting
East Elmhurst, NY2 days ago$29 - $52 per hour
...and drive alignment between care providers and payers, and ultimately... .... The Clinical Claim Review RN will be responsible for... ...payment. This position will utilize information from claims data... ...disparities and improves health outcomes - an enterprise priority reflected...Hourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaRemote workMonday to FridayShift workRegistered Nurse
Brooklyn, NY2 days ago- ...BJC HealthCare is seeking a registered nurse to join a remote Utilization Review team. The role supports multiple hospital units with no patient communication, and it is designed for local remote work with weekend rotation. Responsibilities include applying Interqual...Local areaRemote workWeekend work
BJC HealthCare
Brooklyn, NY1 day ago $50 - $55 per hour
...RN – Utilization Management New York, NY – Midtown $50–$55/hour Monday–Friday, 9:00 AM–... ...an RN with a health insurance or managed care background and strong experience on the... ...experience, including medical necessity reviews, prior authorizations, appeals, and benefit...Permanent employmentTemporary workMonday to FridayGreen Key Resources
Brooklyn, NY3 days ago$28.94 - $51.83 per hour
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$40 per hour
...chronically ill patients. Our centers care for people by providing... ...of the Registered Nurse Clinician is to provide medically prescribed... ...clinic setting. Effectively utilize the nursing process to assess... ...For further information, please review the Know Your Rights notice from...Full timePart timeReliefImmediate startWork from homeMonday to Friday$77.08k - $119.47k
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted on: Posted Todayjob requisition id: 71163Department/Unit:Care Management/Social WorkWork Shift:Day (United States of America)Salary Range:$77,075.00 - $119,466.0...Shift work- ...time orientation for 2 full weeks, Monday - Friday from 8am-4:30pm. Requirements 2 years of RN experience performing care for hospitalized patients 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity Must live within one...Full timeReliefLocal areaRemote workMonday to FridayFlexible hoursShift work
$75k - $88k
...application process. Clinical Reviewer RN - Alabama Alabama, US Salary... ...that has engaged in health care quality consulting and quality... ...care delivery and patient outcomes. Our talented remote workforce... ...Overview We are seeking Clinical Utilization Review Nurses (RN) based in...Full timeContract workRemote work$77.91k - $116.86k
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Compu-Vision Consulting
Elmhurst, NY3 days ago - ...physical health. Utilizes the nursing process... ...of direct patient care. Assists all patients... ...of the treating clinician, in accordance... ...collection, health outcomes reporting, clinical... ...refills for Provider review and approval.... ...Current NY State RN License required....Hourly payContract workWork at officeLocal areaImmediate startFlexible hours
One Brooklyn Health System, Inc.
Brooklyn, NY1 day ago - ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to work remotely from home in Louisiana... ..., and support discharge planning and care management across the member continuum... ...inpatient experience, and 2+ years in utilization management or related fields. #J-18808...Remote workWork from homeWeekday work
CVS Health
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PRIDE Health
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$77k - $92k
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