RN - Utilization Review
Health Advocates Network
Benefits We Offer:
- Comprehensive health, prescription, dental, vision, life, and disability plans
- Competitive pay rates
- Referral opportunities ? Refer a friend & Cash in!
- Travel reimbursement and per diem allowances
- Employee discounts
- Educational opportunities
Health Advocates Network was founded based on a shared aspiration to improve the way healthcare staffing is done. We are a company founded by healthcare professionals and built for healthcare professionals. As your true advocates, we will always help you thrive and pave the path forward in your career. Our talented staffing team is committed to providing exceptional customer service, great opportunities with top pay and benefits. From Per Diem to Travel Contracts, miles away or local to you, Health Advocates Network can find you just what you are looking for. Allow us to get you to you next adventure!
Health Advocates Network, Inc. is an equal opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis under applicable federal, state or local law, except where a bona fide occupational qualification applies. EOE including Veterans/Disability
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the RN - Utilization Review in Syracuse, NY vacancy
- A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities, certification reviews, and collaborating with healthcare providers. Candidates must have an RN License in NY and at least...SuggestedMonday to Friday
- ...With level of care screening criteria such as MCG or Interqual, CMS regulations as related to hospital admissions, Utilization management or utilization review, and interfacing with health care payers/regulatory agencies. Benefits Becoming an AMN Healthcare...SuggestedTemporary work
Trinity Clinics AMN
Syracuse, NY1 day ago - Job Title With level of care screening criteria such as MCG or Interqual, CMS regulations as related to hospital admissions, utilization management or utilization review, and interfacing with health care payers/regulatory agencies. AMN HealthcareSuggested
$65 per hour
...RN Case Manager / Utilization Review - Syracuse, NY (#25268) Location: Acute Care/Academic Medical Center, Syracuse, NY Employment Type: Full-time Hourly Rate: $65/hour About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing...SuggestedHourly payFull timePrivate practiceMonday to FridayDay shiftGreenLife Healthcare Staffing
Syracuse, NY2 days ago- A healthcare organization in Texas is seeking an RN Utilization Review Coordinator to perform utilization reviews and ensure medical necessity compliance. The role involves collaborating with healthcare teams, managing denial appeals, and supporting discharge planning....SuggestedFull time
- HUMBLE VASCULAR SURGICAL CENTER INC in Addison, Texas, is seeking a dedicated RN Case Manager to oversee utilization reviews and discharge planning. The role involves ensuring compliance with medical necessity guidelines while collaborating with physicians and interdisciplinary...
- ...Utilization Review RN Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are:...ReliefLocal areaImmediate start
- Baylor Scott & White Health is seeking an experienced Utilization Review RN to review cases for medical necessity across insured patients. You will apply clinical criteria, coordinate with care teams, and support efficient resource use. You will communicate with health...
- ...Description Summary: The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients... ...LVN license in the state of employment or compact required RN license in state of employment or compact preferred Work...Full time
Christus Health
Irving, TX20 hours ago - ...Job Title Supervise utilization review for RNs. Oversee processes daily. Guide on complex cases. Identify staff education opportunities. Connect departments through communication. Essential Functions of the Role Supervising Utilization Review Department, assigning...Work at office
- ...RN Utilization Review Coordinator The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure appropriate patient status, medical necessity, and compliance with hospital policy, payer...Full timeLocal area
- A healthcare institution in Addison, TX seeks an experienced Registered Nurse (RN) to oversee the Case Management team focusing on Utilization Review. Responsibilities include managing departmental operations, ensuring compliance with regulations, and improving care coordination...Full time
- ...Description Day to Day Responsibilities: Conducts utilization management activities in accordance with... ...to calls, conducts certification reviews, facilitates the discharge planning and referral... ...AT (***) ***-**** ASAP! Qualifications RN License in NY with 2 years of experience...Hourly payCasual workPrivate practiceWork at officeImmediate startMonday to Friday
- ...Partners, Inc. leads the case management team with a strong focus on utilization review, ensuring compliant care and reducing unnecessary hospital... ...optimize care coordination and outcomes. Requirements include RN license with BSN, UR/UR-related credentials, and 3+ years...
- Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care coordination services and is responsible... ...in member care. Rotating weekend hours are required to address utilization review cases. Roles and Responsibilities Prepares clinical reviews...Live inRemote workFlexible hoursWeekday work
- A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Full timeRemote work
Innovative Systems Group
Richardson, TX1 day ago - Benefits We Offer: Comprehensive health, prescription, dental, vision, life, and disability plans Competitive pay rates Referral opportunities ? Refer a friend & Cash in! Travel reimbursement and per diem allowances Employee discounts Educational opportunities...Daily paidLocal area
HAN Staff
Syracuse, NY4 days ago - Evry Health is seeking an RN Integrated Care Coordinator (UM) to provide comprehensive care coordination and drive quality outcomes... ...-quality care in a remote environment, with rotating weekend utilization review coverage. The candidate should have 1-2 years in utilization...Remote job
- Baylor Scott & White Health in Dallas, TX seeks a supervisor to oversee Utilization Review for RNs and guide daily processes. The role focuses on complex case guidance, staff education opportunities, and interdepartmental communication to enhance care quality. Responsibilities...
- An established industry player is seeking a dedicated Registered Nurse for a remote contract position focused on reviewing medical claims within the insurance sector. This role involves validating treatment plans using accepted criteria and requires strong communication...Remote jobContract work
$16.74 - $26.92 per hour
...Utilization Review (Ur) Intake Specialist The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and forms completion in addition to answering incoming telephone calls, supporting the goals...Hourly payMinimum wageFull timeWork at officeLocal areaFlexible hoursCorVel
Dallas, TX2 days ago- A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have...Remote workFlexible hours
Medical Review Institute
Dallas, TX3 days ago - Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or... ...Qualifications: Graduate of an accredited school Valid current RN license in good standing Able to perform the professional and...
- About the Role The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level... ...behavioral health or chemical dependency setting. Licensure: Current RN, LCSW, or LPC license preferred. Skills and Competencies: In...Full timePart timeWeekend work
- A healthcare organization is seeking Board-Certified physicians in Oncology for a flexible, remote utilization review role. This position requires a Medical Degree (MD or DO) with a current license in Florida, Minnesota, or Oregon, and an active Board Certification in...Remote jobFlexible hours
- ...responsibility” assigned to the Inpatient Services RN, for a limited period of time, and for specific... ...ensure efficient patient scheduling and staff utilization in accordance with the TAP scheduling tool. Maintain and review the daily TAP tool for all hospitals/facilities...Local area
Fresenius Medical Care
Dallas, TX1 day ago - ...Description Summary: The RN Navigator Home Health Review plays a crucial role in monitoring post-acute patients to ensure they continue to... ...Home Health recertification or discharge from service. Utilizes MCG Guidelines for post-acute services and Home Care to optimize...Full timeWork at officeMonday to Friday
Christus Health
Irving, TX20 hours ago - ...must reside in IL or TX Contract: 12/22/2025 to 03/31/2026 RN working in the insurance or managed care industry using medically... ...is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation...Full timeContract workRemote work
Innovative Systems Group
Richardson, TX3 days ago - ...Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and...Remote jobContract work
- Description Summary: The RN Navigator Home Health Review monitors home health patients to ensure patients continue to meet the CMS criteria for services... ...Home Health recertification or discharge from service. Utilizes MCG Guidelines for Home Care to optimize the type,...Full timeWork at office
Christus Health
Irving, TX20 hours ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN - Utilization Review. Be the first to apply!
