Utilization Review Nurse Jobs

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1000+ Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 25714
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...
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...
The Utilization Management (UM) Review Nurse (Inpatient or Outpatient) performs chart reviews to determine medical necessity of requested outpatient services or inpatient stays, while maintaining compliance with appropriate nursing standards and all regulatory requirements. Interfaces with medical directors, and both internal and external stakeholders, in regards to coverage for services, contract...
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 ...
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...
JOB DESCRIPTION Manager / Denials - Utilization Review / Registered Nurse MANAGER LEVEL POSITION- Valid RN License BSN preferred; Certification as a CPHQ, CCM, ACM or IQCI preferred 5 years experience in Ultization Management, denials management or related field Knowledge of hospital billing systems preferred. Knowledge of statistics, data collection, analysis and data presentation. Knowled...
*CURRENTLY INTERVIEWING* Job Summary of the Registered Nurse (RN) / Inpatient Case Manager / Utilization Review: • Collaborate with patient/family/health team to identify the appropriate resources needed for the next level of care • Resolve patient care issues that may impact length of stay, cost and/or quality of care. • Monitor daily operations that may impact patient care/pace of care and t...
Utilization Review Nurseneeded for acontract to hireopportunity with Yoh's client located in Santa Clara, CA. Top Skills Should You Possess: - Experience in Managed Care or Case Management - Knowledge of Medi-Cal & Medicare What You'll Be Doing: - Day-to-day utilization review for inpatient and outpatient activities, utilizing approved policies, standards, and clinical criteria - Proactively...

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Healthcare Career Tools

Nurse Manager

Salaries

$53,040.00 - $103,400.00
Typical Salary for Nurse Manager
(313 Respondents)
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Education / Training

Bachelor's
41.2%
Master's
30.6%
Associates
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(216 Respondents)
Source: Monster.com Careerbenchmarking Tool

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