Average salary: $80,686 /yearly
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- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators...SuggestedRemote jobPermanent employmentWork experience placementReliefLocal area
- ...Job Title: Concurrent Review Nurse Position Purpose The Concurrent Review Nurse is responsible for performing concurrent... ...appropriate level of care. Review acuity level, resource utilization, length of stay, and discharge planning to ensure quality and...Suggested
- ...What To Expect Tesla is looking for a Utility Field Service Technician to work across the entire Tesla organization to problem solve and ensure the success of our large-scale utility energy assets. Tesla needs a diversely talented and skilled technician ready to move...SuggestedFull timeTemporary workWork at officeFlexible hoursWeekend work
- ...Anyone who has implemented service cloud V2 for Utility industry & can lead design workshop can play this role. CX Lead - Service Cloud V2 This is a lead level role would entail person to run the design workshop with client. Qualifying Questions:...Suggested
$23k
...crafting careers and creating new legacies. Crafted Highlights: In the role of Sr. Manufacturing Systems Engineer (Brewing & Utilities) working in the Ft. Worth Brewery, you will be part of the Information Technology team. This role is pivotal in driving the...SuggestedTemporary workWork experience placementShift work- ...motivated and proud of the work you do? Here at Aramark, we take pride in the level of service and safety we provide! As a General Utility Worker on our team of other service stars, you’ll take on the important task of maintaining the cleanliness of dishes, equipment, and...SuggestedFlexible hoursAfternoon shift
- ...motivated and proud of the work you do? Here at Aramark, we take pride in the level of service and safety we provide! As a General Utility Worker on our team of other service stars, you’ll take on the important task of maintaining the cleanliness of dishes, equipment, and...SuggestedFlexible hoursAfternoon shift
- ...contracted independent practices. Annual revenues last year exceeded $2 billion. This exceptional position will oversee the group's Utilization management program either from the group's Headquarters in San Antonio, Texas or it may be managed from the home city of the...SuggestedRemote work
$76k - $85k
...challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing a medical management software system on a day-to-day...SuggestedFor contractorsH1bWork at officeLocal areaRemote work- Position Summary The Utilization Review Specialist is responsible for managing and coordinating the utilization review process for inpatient and outpatient behavioral health services. This role ensures medical necessity, timely authorizations, regulatory compliance, and...SuggestedFlexible hours
- ...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...SuggestedFull timeContract workRemote work
- ...more per week. At Bradford Health Services, we don’t just invest in our patients—we invest in our people. About the Role The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while...SuggestedFull timePart timeWeekend work
- ...to achieve Master’s degree within two years of hiring EXPERIENCE Five years in case management with three years including utilization review, with two years in people management in a healthcare setting Expertise with nationally recognized medical necessity review guidelines...SuggestedPermanent employmentWork at office
- LVN or RN Utilization Review Nurse (Administrative Nursing) Are you looking for a challenging and impactful nursing career that will diversify your nursing skills? Tired of working long hours and standing on your feet all day? Want to have work‑life balance? If you enjoy...SuggestedFull timeCasual workWork at officeMonday to FridayShift work
- ...school of Nursing Master’s degree in nursing preferred EXPERIENCE Five years' experience in inpatient case management, social work or utilization management or in the managed care/payer environment, of which one year must have been in a people management role in healthcare;...SuggestedPermanent employment
$98.53k - $120.22k
Overview Job Number: 177079 • Job Title: Utilization Management Review Nurse • Salary: $98,529.60 - $120,224.00 Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. Harris Health champions...Work at officeRemote workFlexible hoursWeekend work- A leading healthcare provider in San Antonio seeks a Utilization Review Coordinator to conduct patient care evaluations and monitor treatment plans. This role involves collaborating with healthcare teams to ensure quality care and compliance with insurance requirements...
- ...research center in Dallas seeks a qualified RN for a medical certification review role. Candidates must have 5 years of experience, including 2 years in clinical settings and 3 years in utilization review, and hold an active, unrestricted RN license in Texas....Relief
- ...growth and development. Job Summary Conduct medical certification review for medical necessity for acute care facility and services.... ...staff on issues related to admission qualifications, resource utilization, national and local coverage determinations and documentation...Daily paidFull timeReliefWork at officeLocal areaMonday to FridayShift workNight shift
- A major healthcare provider in Houston is seeking a full-time Utilization Management Clinical Registered Nurse to oversee precertifications of inpatient and outpatient services. This role involves analyzing clinical requests, collaborating with various disciplines, and...Full time
- A leading healthcare institution in Houston is seeking a qualified Registered Nurse for an inpatient case management role. The ideal candidate will have five years of experience in healthcare management and a background in direct patient care. A Bachelor’s in Nursing and...
- A healthcare institution in Addison, TX is seeking a skilled RN Utilization Review Coordinator responsible for conducting utilization reviews, managing denials, and collaborating with healthcare teams to ensure patient care standards. The ideal candidate should have a...Full time
- A leading healthcare provider in Texas is seeking an experienced nursing manager to oversee case management and utilization review. The ideal candidate will have at least five years in case management, expertise in medical necessity guidelines, and a strong capability...
- A healthcare provider located in Texas is seeking a Utilization Review Specialist to manage the review process for behavioral health services. In this role, you will ensure medical necessity and compliance with payer requirements, requiring at least 3 years of experience...
- ...placed in the appropriate level of care while monitoring the utilization of healthcare resources and discharge planning to achieve the... ...-party payer regulatory requirement. Performs initial status review and level of care placement on all patients in an inpatient status...Shift workDay shift
- A healthcare provider in Van Alstyne, Texas is looking for a Utilization Review specialist to ensure effective coordination of care and compliance with insurance. This role requires a Bachelor's degree in a related field and 2+ years of experience in behavioral health....
- Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape—analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct...
- ...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...Full time
- A healthcare provider in Texas is seeking a full-time Registered Nurse to establish and maintain efficient patient care management. This role involves assessing patients, developing plans of care, collaborating with healthcare teams, and ensuring compliance with medical...Full time
$248.5k - $373k
A healthcare organization is looking for a Medical Director to oversee clinical reviews and support operations. The role emphasizes collaboration in managing medical benefits and ensuring quality care for members. Candidates should possess an M.D. or D.O, hold board certification...Remote job