Average salary: $94,139 /yearly
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$34 - $55 per hour
...for clinical, financial, and resource utilization information. Provides intervention and... ...records days authorized in EPIC 2. Denial Management : Monitors and identifies patterns... ...initiatives Participates in nursing unit and department clinical outcome projects...SuggestedFull timeLuminis Health
Annapolis, MD4 hours ago- A health management organization located in Tulsa, Oklahoma, is looking for a clinical reviewer to join their Utilization Management Team. The role involves assessing utilization requests and implementing care coordination for high-risk members. Candidates must have a...Suggested
- ...healthcare organization in Atlanta seeks an experienced registered nurse to oversee acute hospital admissions and ensure appropriate... ...hold a current RN license in Georgia, with a master's degree and utilization review experience preferred. The role offers a flexible...SuggestedFlexible hours
$60.2k - $107.4k
...scale. Join us to start Caring. Connecting. Growing together. Utilization Management RN Coder will accurately and efficiently review and extract... ...while providing high quality reviews. The Appeals nurse will perform their job functions, adhering to both Optum and...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote work- A leading staffing firm in Miami seeks a Registered Nurse for Utilization Management. The ideal candidate will have at least 3 years of nursing experience in a critical care setting and be skilled in medical necessity reviews and authorization processes. Responsibilities...Suggested
$100k - $110k
A leading correctional healthcare provider is seeking a Utilization Management RN to serve as a Regional Office Case Manager. Responsibilities... ...coordinating patient care plans. Applicants should have a Registered Nurse Licensure and at least one year of experience. This full-...SuggestedFull timeWork at office- Utility Management Nurses (Insurance Coding & Revenue Management) We are seeking a dedicated Utility Management Nurse specializing in Insurance Coding & Revenue Management in Oklahoma City, OK. Responsibilities Accurately code insurance claims and manage revenue cycles...SuggestedFull time
$54.1k - $116.76k
...be a 12.5% differential for this shift. Utilizes clinical skills to coordinate, document... ...all aspects of the utilization/benefit management program for preauthorization for mental... ...Education If RN, Bachelor's degree in nursing required with emphasis on Behavioral Health...SuggestedHourly payFull timeTemporary workLocal areaWork from homeFlexible hoursShift workWeekend work- ...& development Vision insurance Location: Outpatient Case Management West Los Angeles VAMC, 11301 Wilshire Blvd, Los Angeles,... ...Angeles VA Medical Center. Job Summary: We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse, you...SuggestedWork at officeRelocation packageFlexible hours
- A healthcare organization is seeking a Registered Nurse-Utilization Management to ensure effective nursing practices and quality improvement. The role involves educating internal and external clients on clinical standards, collaborating with interdisciplinary teams, and...Suggested
- ...Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits...SuggestedContract work
$72.8k - $130k
...to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results... ...for remote work based on business needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring...SuggestedMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal areaRemote work- ...Clinical Research, Rehabilitation Therapy, and Nursing. Job Description Location: Downers Grove... ...successful and timely return to work. Manage services, strategies, policies, and... ...management, clinical coverage, and policies. Utilize clinical skills to coordinate, document,...SuggestedWork at officeWeekend work
- A leading healthcare organization in Florida seeks a Utilization Management Staff RN to oversee the Utilization Management program for inpatient... ...teams. Candidates should be graduates from an accredited nursing program with a valid RN license and at least five years of...Suggested
- A leading healthcare staffing firm is seeking a Utilization Management Nurse for a fully remote position. The role involves reviewing medical records, applying clinical guidelines, and communicating with providers. Candidates must have an active RN license and at least...SuggestedRemote jobHourly payFull timeContract work
- ..., or DE for permanent conversion) Position Type: Contract (6-12+ months) with potential for full-time conversion As a Utilization Management Nurse, you will: Review medical records to determine medical necessity for services Apply clinical guidelines such as InterQual...Remote jobHourly payPermanent employmentFull timeContract work
$23.79 - $38.86 per hour
Job Summary Utilization Review, Utilization Management, Advocacy and Education Clinical Analysis and Data Management Clinical Care Management/Coordination... ...\'s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master\'s of Science in Nursing (MSN) preferred...Temporary workWork experience placementReliefShift work$89.07k - $162.8k
...Coordinates negotiates procures and manages care of our members/enrollees to facilitate... ...Columbia Contract for the population served. Utilizes standards/ guidelines to manage and... ...Graduate of an accredited School of Nursing required and Bachelor's degree preferred...Full timeContract workWork at officeRelocationMedStar Health
Washington DC2 days ago$32.01 - $68.55 per hour
...and every day. Position Summary This is a fulltime remote Utilization Management opportunity for RNs with a New York state licensure. The schedule... ...- Friday, 8:30am - 5pm EST. This role is a registered nurse that utilizes MCG rules and applies medical necessity guidelines...Hourly payFull timeTemporary workLocal areaRemote workMonday to FridayFlexible hours$66.58k - $142.58k
...one family and one community at a time. Behavioral Health Utilization Management Clinician Position Summary Join a team that’s dedicated to helping... ...independent clinical behavioral health or registered nurse license in the state of residence; accepted licenses include...Hourly payFull timeTemporary workLocal areaFlexible hours- ...leads to tomorrows cures for conditions such as heart failure, cancer and other diseases. The role you'll contribute The Utilization Management nurse uses clinical expertise to review patient records in the emergency department setting and provide a recommended level of...Full timeLocal areaShift workNight shift
$26.01 - $74.78 per hour
...more convenient and more compassionate. This position is with Utilization Management, a 24/7 operation where work schedules may include weekends... ...Qualifications 3+ years of experience as a Registered Nurse Active current and unrestricted RN licensure in state of residence...Hourly payFull timeTemporary workWork at officeLocal areaFlexible hours- A health care enablement company is seeking a Utilization Management Nurse to work remotely. Responsibilities include performing clinical reviews, collaborating with healthcare partners, and ensuring compliance with regulatory standards. Candidates should be a licensed...Remote job
- 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
- A leading healthcare provider in Idaho is seeking a Utilization Management Nurse to monitor healthcare service utilization. This role emphasizes proactive management and effective communication with providers to ensure quality patient care. Required qualifications include...Remote job
- A major healthcare provider is seeking a Registered Nurse for Utilization Management in South Carolina. This full-time role requires 2+ years of experience in acute care and active RN licensure. Responsibilities include assessing healthcare services and coordinating care...Full timeFlexible hours
$71.61k - $111k
Utilization Review Nurse page is loaded## Utilization Review Nurselocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted... ...Yesterdayjob requisition id: 67356Department/Unit:Care Management/Social WorkWork Shift:Day (United States of America)Salary...Shift work- Job Title: “Nurse Case Manager II - Transition OD Care Registered” Estimated Length of Assignment: 5 Months (with possible extension) Est... ...member’s needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in...Work at officeLocal areaImmediate start1 day per week
- A healthcare company is seeking a Registered Nurse for Utilization Management in Michigan. This role involves reviewing services and patient care quality, conducting stay reviews, and preparing appeals to payors. Candidates must be licensed in Michigan with three years...Work at office
- A healthcare staffing firm is seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive...
