Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Imaging Utilization Nurse Reviewer

Jobtailor

Jobtailor is seeking a licensed registered nurse to perform preauthorization reviews for diagnostic imaging, focusing on medical necessity and treatment appropriateness. You will collaborate with providers and members to optimize benefits and ensure high-quality outcomes. The role requires nursing experience, familiarity with UM guidelines, ICD-10/CPT-4 coding, and experience in utilization or quality management or call centers. On-site work is preferred in various settings. #J-18808-Ljbffr Jobtailor

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Imaging Utilization Nurse Reviewer in Florida, NY vacancy
  •  ...network and appropriateness of treatment reviews for diagnostic imaging services using appropriate policies,...  ...of treatment. Requirements AS in nursing and minimum of 3 years of clinical...  ..., or minimum of 1 year of prior utilization management, medical management and/or... 
    Suggested

    Jobtailor

    Florida, NY
    2 days ago
  • $40 per hour

     ...Nurse Reviewer PT (20‑30 hours week) – Remote Work Environment Non‑Exempt: $40.00 hour Supports Medical Review Services. The Nurse...  ...Evaluate medical claims against industry standards, utilizing research of relevant ICD‑10, CPT, and HCPCS codes to determine... 
    Suggested
    Contract work
    Work at office
    Local area
    Immediate start
    Remote work

    Healthcare Quality Strategies

    Florida, NY
    10 hours ago
  • A healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an active RN license, along with experience in medical record review. Responsibilities include... 
    Suggested
    Remote job
    Hourly pay
    Part time
    Flexible hours

    Healthcare Quality Strategies, Inc. (HQSI)

    Florida, NY
    2 days ago
  • A healthcare organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The role involves examining claims, maintaining knowledge of Medicaid policies, and managing the screening process effectively. Candidates must... 
    Suggested
    Remote job

    Healthcare Quality Strategies, Inc. (HQSI)

    Florida, NY
    4 days ago
  • Healthcare Quality Strategies, Inc. (HQSI) is seeking a Nurse Reviewer for a remote position supporting Medical Review Services. The role requires conducting comprehensive medical necessity reviews and ensuring compliance with established guidelines. The ideal candidate... 
    Suggested
    Remote job

    Healthcare Quality Strategies, Inc. (HQSI)

    Florida, NY
    2 days ago
  • $71.1k - $97.8k

     ...Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation...  ...related field Prior experience in utilization management/review and or prior authorizations. Background in case management... 
    Full time
    Temporary work
    Apprenticeship
    Work at office
    Local area
    Remote work
    Work from home
    Home office
    Monday to Friday
    Shift work

    Humana

    Florida, NY
    3 days ago
  • HCA Florida Woodmont Hospital is seeking a PRN IR RN to join our imaging team. The Radiology Nurse will provide patient care across the lifespan within the Imaging Department, including contrast administration and sedation as needed. The role reports to the Medical Director... 
    Relief

    HCA Florida Woodmont Hospital

    Florida, NY
    2 days ago
  •  ...healthcare providers to maintain compliance with utilization management guidelines and optimizing...  ...Three (3) years of critical care nursing experience, or Five (5) years of medical...  ...experience, or Three (3) years of utilization review, case management, or third-party payer... 

    UF Health

    Florida, NY
    1 day ago
  • Description PRIMARY PURPOSE: To support utilization management, quality improvement, population...  ...activities. 2. Utilization Management Review utilization data to identify trends in...  ...QUALIFICATIONS: Associate Degree in Nursing required ; Bachelor of Science in Nursing... 
    Work at office

    FoundCare, Inc.

    Florida, NY
    2 days ago
  •  ...leading healthcare staffing firm is seeking a qualified clinical nurse for a utilization management role. Candidates should possess at least 2 years...  ...healthcare staff to ensure quality care and involves reviewing medical necessity. Applicants can reach out to the recruitment... 

    Healthcare Support Staffing

    Florida, NY
    2 days ago
  •  ...healthcare organization is seeking an experienced Registered Nurse (RN) in Florida. The role involves evaluating patient medical...  ...management guidelines. Candidates should have strong experience in utilization review or case management and excellent communication skills. This... 

    UF Health

    Florida, NY
    5 days ago
  •  ...TurningPoint Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities include performing initial clinical reviews,... 
    Remote work

    TurningPoint Healthcare Solutions

    Florida, NY
    2 days ago
  • CVS Health seeks a Medicare Precertification Utilization Management Nurse Consultant for a 24/7 operation. The role focuses on assessment, coordination of care, and collaboration with providers to optimize benefits for members. Requires Associates degree (BSN preferred... 
    Remote job
    Shift work
    Afternoon shift

    4062 Aetna Resources, LLC

    Florida, NY
    3 days ago
  • Health Business Solutions LLC seeks an experienced Utilization Review Nurse in New York to provide clinical guidance, drive appropriate level of care, and support revenue cycle efficiency. You will conduct medical record assessments, coordinate care with interdisciplinary... 

    Health Business Solutions LLC

    Florida, NY
    2 days ago
  •  ...of an accredited school of professional nursing. BSN preferred Experience / Qualifications...  ...nurse has a working knowledge of breast imaging protocols, conditions, MQSA and ACR...  ...performed when circumstances change. I have reviewed these job requirements and verify that I... 
    Relief
    Local area

    Jupiter Medical Center

    Florida, NY
    3 days ago
  • Job Summary We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play a crucial role in supporting our clients in the healthcare industry by providing expert clinical guidance, facilitating effective... 
    Work experience placement

    Health Business Solutions LLC

    Florida, NY
    2 days ago
  • IHCS seeks a Utilization Management Nurse to ensure home health services are delivered with quality, cost efficiency, and compliance. You will review patient treatment files, perform concurrent reviews, and coordinate care with a multidisciplinary team. State licensure... 

    Ellenco Estágios e Treinamentos

    Florida, NY
    5 days ago
  • Broward Health in Florida seeks a registered nurse in Case Management to coordinate and manage an assigned caseload, promote evidence-based outcomes, and support utilization management to determine appropriate levels of care. The role emphasizes discharge planning, compliance... 

    Broward Health

    Florida, NY
    3 days ago
  •  ...services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a...  ...licensure and a minimum of 3 years of nursing experience, preferably in critical care...  ...Candidates should have experience with Utilization Review, familiarity with Interqual Criterion... 

    Fabergent

    Florida, NY
    2 days ago
  •  ...recruiting firm in New York seeks an experienced RN Supervisor for the Utilization Management department. Responsible for supervising daily...  ...must have a background in utilization management, clinical nursing, and supervisory roles. The position offers a fun work environment... 

    Healthcare Support Staffing

    Florida, NY
    4 days ago
  •  ...accredited school of professional nursing, BSN preferred Experience /...  ...include, but not limited to: Utilize Nursing Process to set goals,...  ..., development and public image of Jupiter Medical Center and...  ...circumstances change. I have reviewed these job requirements and verify... 
    Full time

    Jupiter Medical Center

    Florida, NY
    1 day ago
  • AdventHealth Apopka is seeking a Registered Nurse to provide comprehensive assessments, develop individualized care plans, and coordinate with the care team to deliver high-quality patient care in an acute hospital setting. You will administer medications, educate patients... 
    Relief
    Day shift

    Direct Jobs

    Florida, NY
    2 days ago
  • Leon Medical Center in New York is seeking a Concurrent Review Nurse to ensure medically necessary, high-quality, and cost-effective care through inpatient and outpatient care reviews, leveraging CMS guidelines and established medical policies. You will lead clinical review... 

    Leon Medical Center

    Florida, NY
    5 days ago
  • First Coast Service Options is seeking a Clinical Review Nurse to evaluate medical necessity, coverage, and payment levels for Medicare-related claims. The role applies clinical knowledge to determine the appropriateness of care in line with CMS policies and standards.... 
    Remote job

    First Coast Service Options

    Florida, NY
    4 days ago
  • Molina Healthcare is seeking an RN to support clinical member services review assessment processes in New York. You will verify medical necessity and alignment with guidelines, coordinating care across the continuum to reach desired outcomes. Responsibilities include prior... 

    Molina Healthcare

    Florida, NY
    2 days ago
  • $26.41 - $51.49 per hour

    Molina Healthcare in California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service requests, ensuring compliance with regulations, and collaborating with teams for healthcare delivery. The ideal candidate has an active RN license... 
    Hourly pay

    Molina Healthcare

    Florida, NY
    4 days ago
  • A leading healthcare staffing firm is seeking a Registered Nurse for Concurrent Review in Florida. The role involves telephonic review of inpatient admissions to ensure appropriate medical necessity and care levels. Candidates must have an active RN license in Florida and... 
    Full time
    Work at office
    Monday to Friday

    Healthcare Support Staffing

    Florida, NY
    2 days ago
  •  ...provides safe and effective nursing care and treatment to patients...  ...in patient care processes. Utilizes and ensures staff uses supplies...  ...and helps portray a positive image of the hospital in the...  ...treatment and at time of discharge. Reviews with the Physician all... 
    Shift work

    Health Care District of Palm Beach County

    Florida, NY
    5 days ago
  • The University of Miami is seeking a Registered Nurse 2 - Radiology Specialist for a full-time, on-site role in Doral, FL. You will deliver patient-family centered care, supervise nursing staff, and support radiology procedures with evidence-based practice. Requires a Florida... 
    Full time

    University of Miami

    Florida, NY
    2 days ago
  • $112k - $140k

     ...complex patients Visit skilled nursing facility (SNF) residents in...  ..., perform physical exams, review medications, and assess clinical...  ...interpret diagnostics (labs, imaging, EKGs, and other tests within...  ...specialists, and care teams Utilize remote monitoring data,... 
    Daily paid
    Full time
    Work at office
    Remote work
    Flexible hours
    Weekend work

    5-50 GROUP LLC

    Florida, NY
    5 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Imaging Utilization Nurse Reviewer. Be the first to apply!