Utilization Review Supervisor — RN Lead & Compliance
BBSS Beyond Blue
Beyond Blue is seeking a Supervisor, Utilization Review to lead the daily operations of the utilization review team in the UK. The role ensures compliance with payer guidelines and regulatory standards while guiding staff performance and quality assurance. Responsibilities include coordinating with physicians, payers, and interdisciplinary teams to optimize patient care and reimbursement, delivering timely authorization determinations, and contributing to policy development. #J-18808-Ljbffr BBSS Beyond Blue
- INTEGRIS Baptist Medical Center in Oklahoma City, OK is seeking a day shift/variable, full-time RN Case Manager - Utilization Review. You will assess patients, coordinate transfers, and develop discharge plans to optimize resources and patient outcomes. Qualifications...SuggestedFull timeDay shift
- Beyond Blue Job Posting Title: Supervisor, Utilization Review Requisition Number: R-000003688 Department... ...the utilization review team to ensure compliance with regulatory requirements, payer guidelines... ...related/progressive experience as an RN or in Utilization Review An...SuggestedFull timePart timeWork experience placementReliefInternshipShift work
$77.08k - $119.47k
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted on: Posted Todayjob requisition... ...cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as indicated. • Communicates...SuggestedShift work$2,749.5 per month
...Job Type Travel Offering Nursing Profession RN Specialty Case Manager Job ID 35546746 Job Title RN - Utilization Review (000298) Weekly Pay $2749.5 Shift Details Shift Day -...SuggestedWeekly payShift work$2,883.5 per month
...Hospitals Corporation-Rikers Island Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 19030015 Job Title RN - Utilization Review Weekly Pay $2883.5...SuggestedWeekly payShift work- ...Skills: ~1 year of non-acute utilization review experience - required ~ RN experience - preferred Certification: New York State RN License Primary Source Verification AHA BLS Shift: ~8:30 AM-5:00 PM ~42.50 houris/week...Shift work
- ...Job Title: RN - Utilization Review (000298) Keywords: Number of Positions: 1 Remaining Positions: 1 Duties: 1 year of non-acute utilization review experience - required RN experience - preferred This is the pay range that RightSourcing (a part of Magnit) reasonably expects...
$2,940.02 per month
...HHC Correctional Health Services Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 19018147 Job Title RN - Utilization Review (000298) Weekly Pay $2940.02...Weekly payShift workDay shift- ...RN - Utilization Review Number of Positions: 1 Remaining Positions: 1 Duties: 1 year of non-acute utilization review experience - required RN experience - preferred This is the pay range that RightSourcing (a part of Magnit) reasonably expects to pay someone for...
- ...Performs clinically orientated medical chart reviews and other administrative tasks to meet the requirements of the medical center's utilization review plan, state and federal... ...WELCOMING YOU TO OUR TEAM!! Utilization Review RN - Per Diem* *IMPORTANT NOTE: In lieu of benefits...Hourly payDaily paidWork experience placement
$55 - $65 per hour
...Registered Nurse With Utilization Review Experience A healthcare organization is seeking a Registered... ...and requires an active New York State RN license. The ideal candidate will have... ...of review activities. Support compliance with organizational, regulatory, and payer...Hourly payContract work- ...Visiting Nurses is seeking an experienced OASIS RN to join our in-office clinical team in Pennsylvania. You will review OASIS assessments and support staff to ensure accurate, complete documentation and Medicare compliance. You’ll collaborate with clinicians, stay...Work at office
$110k
...outcomes in the expected time frame and with the most efficient utilization of resources. Carries out activities related to utilization... ...physician regarding appropriate documentation for justification. Reviews the patient’s plan of care in conjunction with the clinical...Daily paidFull timePart timeFlexible hoursShift work$55k - $75k
...them for fulfilling, post-treatment lives. We are seeking a Utilization Review Coordinator to add to our dynamic team. The Utilization Review... ...review activities, decisions, and communications in compliance with organizational policies and legal standards Stay current...Full timePart timeWork at officeRemote work- RN - Utilization Review Shift: Days Shifts Per Week: 5 Scheduled Hours: 40 Start Date: 09/14/2026 End Date: 11/07/2026 Duration: 8 Week(s) City: Elmhurst State: NY VOCA HealthcareShift work
- RN - Utilization Review Shift: 5 Day Shifts X 8 Hrs Start Date: 09/14/2026 End Date: 11/07/2026 Duration: 8 Week(s) City: East Elmhurst State: NY TALENTShift workDay shift
$2,868 per week
...Prime Staffing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in New York City, New York. Job Description... ..., insurance companies, and case managers to ensure compliance with coverage guidelines and supports optimal patient outcomes...Permanent employmentTemporary workZero hours contractShift work$77.02k - $117.58k
...named one of the Tampa Bay Times’ Top Workplaces. Summary The Utilization Review Nurse is responsible for performing initial, concurrent, and retrospective... ...Needed: Yes Minimum Licensure: Registered Nurse (RN) Minimum Licensure (Other): Knowledge of utilization management...Full timeWork at office- MarinHealth is seeking a Utilization Review Nurse II to perform admission, concurrent and retrospective reviews for designated health plans in a 40-hour week on days at Greenbrae, CA. The role requires a BSN preferred, 3+ years of acute care experience, and experience...
- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring accuracy and compliance. You will support OPAS and enterprise... ...reviews. Requirements include an RN license, 3+ years bedside nursing in acute...Remote jobWork at officeFlexible hours
- Carson Valley Health in Nevada seeks a Per Diem Utilization Review RN to perform clinically oriented medical chart reviews and support the hospital's utilization review plan, ensuring medical necessity and proper documentation. Requirements include Nevada RN licensure,...Hourly payDaily paid
- ...Ltd is seeking an Associate Director, Global Medical Review in Princeton, NJ. The role leads high‑impact medical review of safety data for investigational... ...products, ensuring quality and global regulatory compliance. Responsibilities include audits, SOP/guide updates,...
- KPFF Consulting Engineers seeks a SUE Lead in Los Angeles to manage field crews, locate and map underground utilities, and ensure ASCE 38-22 compliance. You will lead operations, mentor junior staff, and coordinate with project managers to deliver accurate documentation...
- ...in Little Rock, AR is hiring a Production Supervisor to oversee daily manufacturing operations, coordinate activities, and lead a team of production workers toward safety,... ...maintenance, quality, and supply chain; ensure compliance with safety standards; drive continuous...
- ...materials at our outdoor facility. You will manage equipment, enforce safety policies, train staff, and ensure productivity and compliance with company standards. This role requires 3–5 years in related industries, a High School diploma, and strong leadership and communication...
- Vistra's Luminant Generation Company LLC is seeking a Protection and Control Supervisor to lead a team of P&C technicians across fossil generation. You will drive compliance, troubleshoot relays and metering, and oversee upgrades and capital projects to improve plant reliability...
$88.85k
...net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of... ...internal teams to ensure accurate adjudication and compliance. This position collaborates closely with internal stakeholders...Full time- Sentara Health Plans Community Care in Norfolk, VA seeks an Utilization Review Nurse to manage utilization management within licensure. You will... ...decisions to members and providers. The role requires a RN license, 3 years of acute care experience, and familiarity with...
$66.83k - $111.38k
...Wisconsin, Wyoming. Job Responsibilities Utilization Review Nurse is responsible for utilizing... ...of treatment setting reviews to ensure compliance with applicable criteria, medical policy... ...Certification/Licensure: Registered Nurse (RN) License (Compact or Virginia) REQUIRED...Remote jobPermanent employmentFull timeTemporary workShift workDay shift- Logan Health in Kalispell, Montana is seeking an experienced RN Supervisor for the Acute Care Unit. This role blends bedside patient care... ...mentoring teammates. You’ll remain actively involved in bedside care, lead during high-acuity situations, and partner with unit...Night shift
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