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$38.16 - $59.15 per hour
...determined by a candidate's expertise and years of experience, among other factors. Position Highlights: Position: RN Utilization Review Location: Naperville, IL Full Time: 40 hours/week Hours: Monday-Friday, 8:00a-4:30p, rotating every 6-8 weekend...SuggestedHourly payFull timePart timeFor contractorsMonday to Friday- A leading medical review organization is seeking Board‑Certified physicians in Pediatric Hematology Oncology for flexible, remote Utilization Reviews. This role requires conducting independent reviews of pediatric cases, engaging in peer-to-peer discussions, and ensuring...SuggestedRemote jobPart timeFlexible hours
- Alliant Health Group is seeking a Pediatric Review Nurse to join their professional multi-disciplinary team in Atlanta, Georgia. This role involves conducting comprehensive medical reviews for Pediatric Programs, managing Medicaid member documentation, and performing clinical...Suggested
- ...We are home to Nevada’s ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are... ...facility by ANCC, and we are on our journey to Magnet status. Review patient admissions for appropriateness, efficiency of resource...SuggestedWork at officeShift workWeekend work
$55 per hour
...Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare... ...: Experience in case management, utilization management, or discharge planning. Experience... ...Nurse, Out-Patient Case Manager Travel Pediatric ICU Registered Nurse - $840 per week...SuggestedFull timeContract workTemporary workLocal areaRemote work- We are seeking a DC licensed RN to perform utilization management reviews, ensuring healthcare services are medically necessary and meet quality standards. The role involves reviewing treatment plans, consulting with providers, documenting decisions, and supporting care...Suggested
$73k - $75k
Utilization Review Nurse PRIMARY PURPOSE To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment...SuggestedWork at officeFlexible hours- Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued - they’re invaluable. Join...SuggestedContract work
$54 - $66 per hour
We are recruiting for a Utilization Review Nurse to join a large healthcare organization within the Sacramento region. The Utilization Review Nurse is responsible for overseeing the daily operations of the UM Pre-Authorization team, ensuring referral requests are processed...SuggestedContract workWork at office- ...success. Job Description • Responsible for conducting timely reviews of all requests for services required to meet medical necessity... ...providers against plan review criteria and benefit guidelines • Utilizes clinical information to determine if criteria for medical necessity...Suggested
- WHAT WE'RE LOOKING FOR We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker’s treatment are effective, efficient, and in accordance with applicable legal requirements. This...SuggestedPermanent employmentFull timeWork at officeWork from home2 days per week
$35 - $40 per hour
Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of home health...SuggestedContract workRemote workFlexible hoursWeekend work$65 per hour
...coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while maintaining high-quality patient... ...care planning and discharge planning. Conduct utilization review to ensure appropriate level of care and services. Collaborate...SuggestedHourly payWeekly payLocal areaShift work- General Summary of Position Job Summary: MedStar Health is looking for a Utilization Review Technician to join our team at MedStar Harbor Hospital. The Utilization Review Technician will collaborate with and assist the multidisciplinary team to meet individualized patient...Suggested
$71.61k - $111k
...Range: $71,612.39 - $110,999.20 Responsibilities Responsible for Utilization Management, Quality Screening and Delay Management for... ...based on Departmental standards. While performing utilization review identifies areas for clinical documentation improvement and contacts...SuggestedShift work- ...PA, NJ, or DE Employment type: Contract to full-time hire Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This position is ideal for an RN with prior work in insurance utilization...Full timeContract workRemote work
- ...compact)) Employment Type: 4-month contract with possibility of extension Overview We are seeking an experienced Inpatient RN Utilization Reviewer to independently manage a clinically complex inpatient caseload across multiple care settings, including acute, subacute,...Daily paidContract workRemote workShift workWeekend work
- ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,... ...in acute clinical care Experience with medical record review/utilization review/utilization management Additional Information Are you...Contract workPrivate practiceMonday to Friday
- ...plan of care for members based on authorization and concurrent review. Provides monthly telephonic outreach to ensure members needs are... ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards,...Contract workRemote workMonday to FridayFlexible hours
- ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately... ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,...Private practiceImmediate start
$2,256.4 per month
Job Overview Our Client is currently seeking Utilization Review for positions in Washington, DC for a 5×8 Days shift. The ideal candidate will possess a current DC license or Compact license depending on the state. You must have a license and at least 1 year of recent...Shift workDay shift- 40 hours per week Position: Utilization Review (UR) Nurse Company Overview Telenett is a leading healthcare company based in Honolulu, HI. We provide innovative and high-quality healthcare services to our clients, including insurance companies, hospitals, and healthcare...Relocation package
- Insight Global is looking for a Utilization Review Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for evaluating 3.5 patient care cases per hour (both inpatient and outpatient) and collaborating with doctors...Hourly payRemote work
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside... ...outpatient services. You’ll use advanced clinical judgment to review medical records, validate care plans, and authorize services that...Immediate startRemote workWeekend workDay shift
- ...medical necessity and appropriateness of the treatment plan . This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from...Full timeContract workRemote work
- ...expanding access to our unique model of care across the United States. Overview Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health...Work at office
- ...knowledge of local and national coverage determinations Recent work experience in a hospital or insurance company providing utilization review services Knowledge of Medicare, Medicaid, and Managed Care requirements Progressive knowledge of community resources, health...Permanent employmentWork experience placementLocal area
$4,801.16 - $7,761.5 per month
...advancement, and more. Benefits of Working at HHS webpage contains additional details. Position Details Functional Title: Utilization Review Nurse Job Title: Nurse II Agency: Health & Human Services Comm Department: UR Wav & Comm Srvs Ran Mmt St Posting Number:...Full timeTemporary workPart timeWork at officeRemote workShift work- Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Required Qualifications Nursing school graduate. California Registered Nurse License upon hire...Minimum wageWork at officeLocal areaShift work
$78.56k - $110.91k
...Location: Remote Facility: Ascension Saint Thomas Department: Utilization Management Schedule: Part Time | Weekends Salary: $78,561.60... ...0 per year What You Will Do: Admissions & Medical Necessity Review: Evaluating service requests and admissions for medical...Temporary workPart timeLocal areaRemote workWeekend work