Utilization Review Nurse Jobs

RSS

574 Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 574
A-Line Staffing has a new permanent job open for RN / Registered Nurse / Utilization Review / Coding / Chart Review / Legal Nurse / clinical documentation specialist / Interqual Hours: Regular business hours 100% in office job RN / Registered Nurse will be the primary resource for the team of Medical Coders. RN / Registered Nurse will be reviewing charts for accuracy to provide proper billing for...
A-Line Staffing has a new permanent job open for RN / Registered Nurse / Utilization Review / Coding / Chart Review / Legal Nurse / clinical documentation specialist / Interqual Hours: Regular business hours 100% in office job RN / Registered Nurse will be the primary resource for the team of Medical Coders. RN / Registered Nurse will be reviewing charts for accuracy to provide proper billing 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 Rev...
Wouldn’t it be nice to work for a company where the mission makes sense, the salaries are competitive, the company listens to the needs of the employees and the office is professional yet the dress is casual? Access Management Services is a health care services and support company serving Colorado Access and its subsidiaries. Colorado Access is a nonprofit health plan supporting the medical, behav...
Tracking Code 1299 Job Description Responsible for coordinating and conducting medical necessity reviews for all Medicare, Medicaid, self pay and all other payers, upon admission and concurrently throughout the inpatient admission. Responsible for the accurate and timely entry of information related to coordination of reviews into AS400, MIDAS, and all other appropriate systems. This position is a...
Job Title: Utilization Review Nurse Location: Phoenix, AZ The position is 8-4:30 or 8:30-5 and Monday Friday. Duties: Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally. Assists and supports customer/account management processes as required. Provides service delivery on assigned products in a manner consistent with established standar...
Seeking a Utilization Review / Management and Case Management Nurse for a health care organization in the South and Southwest areas of Chicago. Full Time, Competitive Pay, Full Benefits offered with a 401K package. Hourly range between $32.00 - $35.00 based on experience. DUTIES AND RESPONSIBILITIES Pre-Authorization, onsite review, discharge planning and retrospective review of inpatients Coordin...
Health Plans Inc., a Harvard Pilgrim Health Care Company, is the region's largest Third Party Administrator. Health Plans provides a comprehensive range of claims and care management strategies to ensure that our clients’ goal of high quality, cost effective health care for their employees is met and exceeded. We specialize in providing claims processing and care management services to clients tha...
Our expanding managed care company is seeking an experienced Registered Nurse for a position in prior authorizations for our Doral office. This position is specific telephonic pre certs. This is a M-F daytime (no holidays/no weekends) in-office permanent position and an excellent opportunity to begin a career with one of the state's leading managed care companies. Salary dependent upon experience...
Piedmont Community Health Plan Lynchburg, VA, 24501
Utilization Review Nurse - RN Piedmont Community Health Plan is a prominent local managed care organization with offices in Lynchburg, Virginia that serves the Central Virginia employer community. PCHP is currently seeking an RN for a full time utilization review position. This position is responsible for reviewing requests for prior authorization of medical services. This position is also respons...
Position Summary: Are you an experienced Registered Nurse (RN) in the Greater Clearwater, FL area looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a Fortune 500 company that provides on-going training and development? Are you interested in working for a company that offers benefits for full-time permanent employees, flex...
Tracking Code 1161 Job Description Responsible for coordinating and conducting medical necessity reviews for all Medicare, Medicaid, self pay and all other payers, upon admission and concurrently throughout the inpatient admission. Responsible for the accurate and timely entry of information related to coordination of reviews into AS400, MIDAS, and all other appropriate systems. This position is a...
Tracking Code 1160 Job Description Responsible for coordinating and conducting medical necessity reviews for all Medicare, Medicaid, self pay and all other payers, upon admission and concurrently throughout the inpatient admission. Responsible for the accurate and timely entry of information related to coordination of reviews into AS400, MIDAS, and all other appropriate systems. This position is a...
The Utilization Review RN is responsible for prospective, retrospective and concurrent Utilization Review activities. He/She is a member of the Multidisciplinary Team, and monitors the documentation for accuracy and clinical compliance. He/She is also responsible for organizing, directing and coordinating Utilization Review activities within the facility in accordance with standards of State and F...
Responsibilities Utilization Management Nurse will manage medically complicated cases through onsite and / or telephonic chart review, consult with physicians and other facility caregivers, assess the condition, diagnosis and treatment plan for members. UM Nurse reviews clinical information utilizing evidenced based clinical guidelines and CHC policies and procedures. Identifies and coordinates di...
Are you a natural born leader among your Registered Nurse (RN) peers? Then look at this inspiring position as the Manager of Utilization Review (UR) in a managed care setting with a Fortune 500 Company. You will be able to allocate your experiences with InterQual (IQ), Utilization Review (UR), and management to lead teams through their day-to-day Utilization Management (UM) tasks. As the Registere...
Job Location: Boston, MA Job Description Functions as the liaison for hospital staff, PCP, other healthcare team members and BMCHP staff telephonically. Educates network providers on Plan benefits and network services. Responsible for maintaining current knowledge of the developments in medical technology, and legislation pertinent to managed care settings, patient rights, safety regulations and B...
Company Confidential New Braunfels, TX, 78132
7am-5pm and 9am-7pm (M-F) Shifts A successful and growing company is currently seeking Utilization Review Nurses for full-time, salary positions, working either a 7am-5pm shift (M-F) or a 9am-7pm shift (M-F). This is an in-office position, located in New Braunfels, TX. We are a FAST-paced and QUALITY driven environment. Requirements: Licensed LVN / RN with ability to review and analyze clinical do...
Case Manager, Inpatient (Concurrent Review) Monday - Friday; 8/hr/day About the Job: Utilization Review, Concurrent Review, Discharge Planning, Transfers Level of Care and length of stay reviews (SI / IS) Reviews, verifies and processes requests for referrals, inpatient and outpatient procedures, home health services, DME Strong problem solving and organizational skills Knowledgeable of: DRG and I...
Company Confidential Baltimore, MD
Healthcare Company looking for an experienced Utilization Review RN to perform medical record review and prior auth reviews on hospital inpatient services. This candidate will perform reviews for a Payer who needs to provide authorizations, for specific services rendered. Required Skills & Experience: Knowledge of Milliman or Interqual criteria Current Licensed RN in the State of MD Strong attenti...

Get new jobs by email for this search
We'll keep looking and send you new jobs that match this search.
email me

Upload your resume and let employers find you!
It's that simple!

Healthcare Career Tools

Nurse Manager

Salaries

$53,040.00 - $103,400.00
Typical Salary for Nurse Manager
(311 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
40.9%
Master's
30.7%
Associates
22.8%
(215 Respondents)
Source: Monster.com Careerbenchmarking Tool

Popular Utilization Review Nurse Articles

Nursing Careers Beyond the Bedside Article Rating
Want to get away from direct care, but keep your seniority? These nonclinical hospital roles could be right for you.
Sample Resume for an RN Career Changer Article Rating
This sample resume demonstrates how experienced nurses can position themselves for jobs outside of the hospital.
For Employers: Post Jobs | Search Resumes | Advertise
About Monster | Work for Monster | Advertise with Us | AdChoices | Partner with Us | Investor Relations | Social Media
Terms of Use | Privacy Center | Accessibility Center | Help | Security | Contact Us | Sitemap | Mobile
©2014 Monster - All Rights Reserved U.S. Patents No. 5,832,497; 7,599,930 B1; 7,827,125 and 7,836,060 MWW - Looking for Monster Cable? - V: 2014.4.35.42-204
eTrustLogo