Nurse reviewer jobs in Philadelphia, PA

28,838 vacancies

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Supervisor, UM Review, Registered Nurse

 ...providing daily oversight of Prior Authorization Clinical Care Reviewers and DME Technicians. Responsibilities include providing clinical...  .../ Experience: ~ Associate’s Degree, Bachelor’s Degree Nursing preferred. ~ Current and unrestricted Registered Nurse licensure... 

Amerihealth

Philadelphia, PA
13 days ago

RN/Registered Nurse - Utilization Review - Pool/Per Diem

 ...Day Shift Description: Nazareth Hospital, a member of Trinity Health Mid-Atlantic, is currently seeking a Utilization Review Registered Nurse to work pool/per diem during the week. The Utilization Management Nurse provides clinically based utilization management... 

Trinity Health Corporation

Philadelphia, PA
6 days ago

Case Manager/ Utilization Review Registered Nurse

MedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is seeking a quality Case Manager/ Utilization Review Registered Nurse (RN) for a travel assignment with one of our top healthcare clients. Requirements: Eighteen months of recent experience in an... 

MedPro Healthcare Staffing

Philadelphia, PA
4 days ago

Clinical Care Reviewer, Concurrent Review, Registered Nurse

The Clinical Care Reviewer is supervised by a UM Supervisor and is responsible for evaluating a member's clinical condition through the...  ...supervisor, and caseload.Education/ Experience:* Registered Nurse graduated from an accredited program. Associate's Degree in... 

Amerihealth Caritas Health Plan

Philadelphia, PA
5 days ago

Clinical Appeals Reviewer, Registered Nurse

Responsibilities:The Clinical Appeals Reviewer reports to an Appeals and Grievances Supervisor and is responsible for processing appeals...  ...'s Degree preferred.* Current and unrestricted Registered Nurse licensure.* 3 or more years' experience in a related clinical... 

Amerihealth Caritas Health Plan

Philadelphia, PA
7 days ago

Nurse Reviewer (Associate or Level I) - Remote

 ...exceptional opportunity to do innovative work that means more to you and those we serve. ********** $5,0000 Sign-On Bonus**********Nurse Reviewers are responsible for conducting pre-authorization, out of network and appropriateness of treatment reviews for diagnostic... 

Anthem Inc.

Philadelphia, PA
4 days ago

RN Telephone Triage Nurse - Pediatrics - Part-Time (Remote)

 ...GENERAL OVERVIEW: Serves as the primary point of contact for patients with a variety of health or illness questions. Provides remote nursing triage to a variety of patient populations across the life spans including infants, the elderly, patients with behavioral needs and... 
Remote job

Allegheny Health Network

Carnegie, PA
6 days ago

Staff Nurse

 ...performed are: Provide and coordinate care by assessing physical and behavioral health needs of patient, develop and implement nursing care plans, maintain medical records and educate patients and their families about various physical and behavioral health... 

White Deer Run of Allenwood

Allenwood, PA
3 days ago

Registered Nurse

Patient First is accepting applications for Registered Nurse in Lehigh Valley, Pennsylvania. Patient First provides a friendly work environment that promotes a team-oriented philosophy. Nurses with all levels of education (e.g., Diploma, Associate, Bachelor’s) are encouraged... 

Patient First

Easton, PA
3 days ago

Director of Utilization Review

 ...RN Director of Utilization Review needed for Direct Hire opportunity with Yoh’s client located in Eagleville, PA . Top Skills...  ...in healthcare related field required; BSN with Active registered nurse licensure or Masters of Social Work preferred Minimum of three... 

Yoh

Eagleville, PA
3 days ago

REMOTE OASIS Chart Reviewer - DIRECT HIRE

 ...OASIS/Chart Reviewers are responsible for reviewing OASIS and/or coding start of care and re-certifications for home health agencies....  ...done by 6:30 PM Eastern. · Company will now pay for renewal of nursing licensure, coding and OASIS. · We will provide a laptop & docking... 
Remote job

Analysts

Philadelphia, PA
3 days ago

Utilization Review RN

 ...REMOTE Utilization Management Registered Nurse (RN) needed for a contract work opportunity with Yoh’s client. Shift: 8am – 4:3...  ...skills What You Will Be Doing: ~Perform telephonic review of hospital admissions and recommend alternative levels of care... 

Yoh

Philadelphia, PA
3 days ago

RN Utilization Review Case Manager

 ...Location: Abington, PA Description: Registered Nurse needed for Utilization Review Case Manager role in Abington, PA. Send your updated resume to ****@*****.*** for quickest response. Details: Full time, M-F (may have to cover 1 weekend every 6 weeks)... 

The Judge Group

Abington, PA
3 days ago

Clinical Reviewer

 ...Job Description Clinical Reviewer Are you an experienced Clinical Reviewer looking for a new challenge? Do you value care...  ...What youll need: Qualifications Active Registered Nurse (RN) license required. Bachelors degree or advanced certifications... 

Kepro

Philadelphia, PA
21 days ago

Clinical Auditor, Case Management/Utilization Management Review

 ...and completes associate quality audits of clinical staff, focused reviews, and problem identification. Provides coaching and feedback to...  ...Degree. Bachelor’s Degree. ~ Current and unrestricted Registered Nurse licensure OR Master’s Degree (Master Level Clinician) preferred.... 

Amerihealth

Philadelphia, PA
27 days ago

Per Diem Clinical Care Reviewer, RN

 ...Discover more about us at esponsiblities: Under the supervision of the Supervisor, Utilization Management, the Clinical Care Review Nurse is responsible for completing medical necessity reviews using policies and procedures, reviewing inpatient and outpatient... 

Amerihealth

Philadelphia, PA
8 days ago

Clinical Care Reviewer Utilization Management

 ...more about us at Responsibilities: The Clinical Care Reviewer is supervised by a UM Supervisor and is responsible for evaluating...  ...’s Degree. ~ Bachelor’s Degree Preferred. ~ Registered Nurse. ~ Registered Nurse graduated from an accredited program. ~... 

Amerihealth

Philadelphia, PA
8 days ago