Average salary: $93,259 /yearly
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- ...Utilization Review Surgery Nurse - RN Position Overview: The Case Manager focuses on clinical quality and resource management resulting in defined clinical satisfaction and financial outcomes. They coordinate patient care to a population of different ages within...SuggestedWork at officeShift workWeekend workDay shift
Singing River Health System
Pascagoula, MS3 days ago - ...healthcare services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a current FL RN licensure and a minimum of 3 years of nursing... ...or ICU. Candidates should have experience with Utilization Review, familiarity with Interqual Criterion,...Suggested
- A healthcare staffing firm is seeking an experienced Registered Nurse (RN) for the role of Utilization Review / Case Manager. Responsibilities include conducting utilization reviews, collaborating with interdisciplinary teams, and ensuring compliance with care plans. The...Suggested
- ...services in an environment of love and care. Summary: The Utilization Review registered nurse performs utilization review and performance... ...: Current or temporary permit Registered Nurse (RN) or Licensed Practical Nurse (LPN) from State of Nebraska- required...SuggestedFull timeTemporary workWork at officeLocal areaFlexible hoursShift work
Faith Regional
Norfolk, NE5 days ago - ...Denials Specialist - Utilization Review(RN) At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands...SuggestedFull timeWork at officeRemote workMonday to FridayWeekend work
BayCare
Tampa, FL3 days ago - A leading professional services firm is seeking a Utilization Review Specialist to perform utilization review services in compliance with regulations. The role involves conducting precertification and concurrent reviews while advocating for patients. Ideal candidates will...SuggestedRemote job
$43 per hour
A healthcare solutions provider is seeking a Medicaid Cost Outlier Clinical Reviewer, RN to perform utilization reviews and quality assessments. The role requires an active RN license in New York and 2+ years of acute care experience. Responsibilities include conducting...SuggestedHourly payPermanent employmentContract work$29.05 - $56.64 per hour
...organization in Omaha is seeking a clinical nurse to facilitate medical claim reviews and support utilization management. The ideal candidate will have at least 2 years of clinical nursing experience, an active RN license, and proficiency in coding. Responsibilities include...SuggestedHourly pay$29.05 - $56.64 per hour
...seeking a clinical professional to conduct reviews of medical claims and internal appeals.... ...clinical nursing experience and an active RN license. Responsibilities include... ...claims, and providing clinical resources for utilization management. This position offers a competitive...SuggestedHourly pay$29.05 - $56.64 per hour
...company is seeking a Registered Nurse to support medical claim reviews and ensure compliance with regulations. The role involves... ...should have at least two years of nursing experience, including utilization review and knowledge of coding. Competitive pay ranges from $2...SuggestedHourly pay- ...evidence based clinical guidelines. Conducts prior authorization reviews to determine financial responsibility Qualifications 2 years... ...with Hospital Nursing (Med-Surg, ER) Well versed in Utilization Management-Must be able to determine elective vs urgent request...SuggestedPrivate practice
- A growing healthcare company in New York seeks a Utilization Review Nurse to conduct clinical reviews and ensure medical necessity authorizations are met. The ideal candidate will be an LPN or RN with critical thinking skills and attention to detail, able to manage tasks...Suggested
- Come lead with us at Houston Methodist Hospital At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and...SuggestedPermanent employmentWork at officeLocal area
$45.9 - $71.4 per hour
...Description Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment...SuggestedMinimum wageFull timeLocal areaRemote workShift workProvidence Health & Service
Portland, OR4 days ago$33 - $37 per hour
A national healthcare staffing firm seeks an experienced RN Utilization Review Nurse in Troy, MI. Responsibilities include utilization review for Medicaid and Medicare, managing authorization processes, and collaborating with healthcare teams to ensure quality care. Ideal...SuggestedHourly payMonday to Friday$55.56 - $85.96 per hour
A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and collaborating with healthcare teams...Hourly pay$25 - $37.47 per hour
A recognized psychiatric treatment center in California is seeking a Utilization Review Specialist to enhance communication between care staff and managed care organizations. The role involves conducting insurance reviews, monitoring patient stays, and providing support...Hourly pay- Utilization Management Dept. Full Time Day Shift 8-4:30 Lexington Health is a comprehensive network of care that includes six community... ...Summary Performs admission and concurrent stay medical record review to determine appropriateness of admission, continued stay, and...Full timeTemporary workWork at officeFlexible hoursDay shift
- 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...Monday to Friday
- 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....Full time
- ...perform precertification and medical necessity reviews on referrals, targeted outpatient... ...role requires a minimum of three years of RN clinical nursing, a valid Georgia RN license... ...Ideal candidates will have experience in utilization management. The position supports a...
$89.07k - $162.8k
...Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates... ...preferred Licenses and Certifications RN - Registered Nurse - State Licensure and/or...RelocationMedStar Health
Leonardtown, MD14 hours ago- ...requires five years of clinical nursing experience, including significant involvement in utilization review and a strong understanding of Medicare and Medicaid. Candidates must hold a Texas RN license and relevant case management certifications. This role emphasizes...
- A leading healthcare institution in New York seeks a Utilization Review Nurse (URN) who will conduct comprehensive medical record reviews to ensure... ...of care. The ideal candidate must be a licensed RN with at least three years of clinical nursing experience and possess...
- A leading healthcare institution in Georgia is seeking a Utilization Review Nurse (URN) PRN. The ideal candidate will oversee reviews of medical... ...experience are preferred. This position requires Texas RN licensure, effective communication, and a strong understanding...Relief
- A leading behavioral healthcare provider in Crown Point, Indiana, is seeking a Utilization Review Nurse (RN or LPN). The role involves coordinating patient services, monitoring health resources, and educating nursing staff. Candidates should have a strong understanding...
- A regional healthcare provider is seeking a part-time RN Utilization Review Specialist in Caledonia, Michigan. The role involves assessing inpatient admissions, advocating for patients within acute care services, and educating medical staff on utilization management. Ideal...Part timeReliefDay shift
- A leading healthcare provider in Houston seeks a Utilization Review Specialist Nurse to conduct medical necessity reviews and collaborate with... ...The role requires a Bachelor's degree in Nursing and a Texas RN license. Candidates should have at least five years of hospital...
- ...employees. Ready to join our quest for better? Job Description The RN Utilization Specialist reflects the mission, vision, and values of NM,... ...expertise in hospital utilization. The RNUS through regular reviews and audits and collaboration with the clinical team,...For contractorsCasual workWork at officeLocal areaRelocation package
$1,787 per week
...Supplemental Health Care is seeking a travel nurse RN Utilization Review for a travel nursing job in Boston, Massachusetts. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours...Contract workLocal areaImmediate startShift workSupplemental Health Care
South Boston, MA14 hours ago
