Utilization Review Nurse Jobs

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1000+ Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 25193
Job Description Registered Nurse (RN) Review Analyst Responsible for the approval or rejection of claims Admissions approvals Telephone triage Benefit interpretation May be required to enter or reference data via PC and/or CRT terminal. Other related skills may be required to perform this job. Expertise in the use of medical terminology Utilization Review Chart Auditing Details 40 hour...
This position is responsible for reviewing and analyzing medical-legal reviews against quality standards and provide feedback to Utilization Review nurses; Understand different medical terminology; Must be extremely detail-oriented, quality driven; Manage time effectively in a fast-paced environment....
Judge Healthcare is actively seeking a full time Utilization Review Registered Nurse for one of our BEST National Healthcare clients!!! This opportunity is located in Syracuse, PA! The right candidate must possess the following qualifications: Active RN license in the state of New York. 1-2 years' of experience in Utilization Review and/or Case Management. Please send your MOST UP TO DATE res...
Judge Healthcare is actively seeking a full time Utilization Review Specialist for an outstanding healthcare client of ours in the Syracuse, NY area! The right candidate must possess the following qualifications: Active RN or LPN license in the state of NY. Utilization Review/Case Management experience REQUIRED. Please send your MOST UP TO DATE resume to Rebecca at ***** or giv...
SBSC, Inc. is seeking an experienced Utilization Review Nurse. Duties include speaking with providers and insurers regarding authorizations and other issues that impact billing and collections. Experience in behavioral health and/or substance abuse a plus. Would require someone who can problem solve, work with insurers, take responsibility,and is committed to accuracy and timeliness. Prefer 3 or ...
Judge Healthcare is currentlyhiring Clinical Care Reviewer for an outstanding opportunity with agreat Healthcare Company in Omaha, NE! We are hiring Nurses (RN) forthis position. Clinical Care reviewers will work to complete medical necessityreviews in a timely fashion. JobDescription Clinical Care Reviewer UM · Using clinical knowledge and nursing experience, the nurse reviewsprovider request...
Title/Unit: RN Case Manager Shift/Schedule: Days Exciting opportunity to join a strong cosmopolitan growing city in the Texas market! Facility/Description: This opportunity is for a major Specialty Hospital in SE Texas. Responsibilites for this Case Manager will be to work with patient/families identified to have discharge planning, psychosocial, financial or other needs to develop a plan th...
Title/Unit: RN- Utilization Review Manager Shift/Schedule: Days 8hr shifts We are seeking a strong Nurse leader who will manage and coordinate the UR/Case Management Dept for a Behavior Health Facility. Facility Description: This Hospital is a 138-bed, privately owned psychiatric and chemical dependency hospital providing a full continuum of care for all ages. The hospital was established in...
UTILIZATION REVIEW MANAGERS $8,058-$9,794/Month The Contra Costa County Health Services Department is currently seeking Utilization Review Managers: one opening is in the Utilization Review Unit of the Contra Costa Regional Medical Center and the other is with the Utilization Review Unit of the Contra Costa Health Plan. Both positions are located in Martinez, CA. Utilization Review or Case Manag...
Judge Healthcare is actively seeking full time LPNs and/or LCSWs for an outstanding healthcare client of ours in the Portland, OR area for a large Utilization Review/Case Management project!! The right candidate must possess the following: Active LPN or LCSW license in the state of Oregon Utilization Review and Case Management experience REQUIRED. Great communication skills-verbal and written....
Title/Unit: Manager of Case Management We are currently seeking a Manager of Case Management to supervise overall case management operations. Facility Description: This facility is committed to providing the care that you and your family will need throughout your lifetime. This Regional Health System has been providing quality and compassionate health care in this community for over 50 years. ...
Alegent Creighton Health Council Bluffs, IA
LPN-UTILIZATION REVIEW Utilization Review FT Days Mercy Hospital Alegent Health - 1400021864 Description Alegent Creighton Health is the largest not-for-profit, faith-based healthcare provider in Nebraska and southwest Iowa with 11 acute care hospitals, a specialty spine hospital, freestanding inpatient psychiatric and skilled nursing facilities and more than 100 Alegent Creighton Clinic locatio...
Catholic Health Initiatives Council Bluffs, IA
LPN-UTILIZATION REVIEW Utilization Review FT Days Mercy Hospital Alegent Health - 1400021864 Description Alegent Creighton Health is the largest not-for-profit, faith-based healthcare provider in Nebraska and southwest Iowa with 11 acute care hospitals, a specialty spine hospital, freestanding inpatient psychiatric and skilled nursing facilities and more than 100 Alegent Creighton Clinic locatio...
Job Summary: Clinical Utilization Review / Appeals / Registered Nurse: • Manage all aspects of the certification for payment process. • Complete admission authorization, out of network transfers, initiates concurrent authorization, completes retrospective authorizations and minimizes financial risk by maintaining timely communication with all payers. • Initiate and complete the appeals process ...
Utilization Review RN Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick Claims Management Services, Inc. has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick CMS is the place for...
Utilization Review RN Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick Claims Management Services, Inc. has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick CMS is the place for...
This is a position that focuses on utilization review including assessment of medical records for appropriateness, level of care provided. You will assess utilization of treatment, modalities, medications, services and application of treatment protocols. A team approach with other members of internal staff is important. Requirements: California Nurses license, Registered Nurse (RN) Utilization ...
UTILIZATION REVIEW NURSE www.pediatricspecialty.com At Pediatric Specialty Care our goal is to enable children with special healthcare needs to realize their fullest potential in a caring, supportive home Pediatric Specialty Care provides innovative and nurturing care to children with complex medical conditions Whether it is transitioning a child back to the family's home or celebrating a sma...
Job Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorization...
Job Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorization...

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Healthcare Career Tools

Nurse Manager

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Education / Training

Bachelor's
41.2%
Master's
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Associates
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(216 Respondents)
Source: Monster.com Careerbenchmarking Tool

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