Utilization Review Nurse Jobs

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165 Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 165
Futures of Palm Beach is a one-of-a-kind residential eating disorders and substance abuse program with un-paralleled clinical programming. We offer evidenced based treatment, with a strong psychotherapeutic approach, with an additional focus developing leading edge treatments in both eating disorders and addictions. Futures is part of a growing company, with additional programs planned for U.S. an...
Overview: As a patient-focused organization, the University of Utah Health Care exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health Care seeks staff that are committed to the values of compassion, collaboration, innovation, res...
Judge Healthcare is currently seeking a Utilization Review Nurse in Syracuse, NY Performs utilization review in accordance with all state and federal mandated regulations. Reviews member records and, using approved criteria and member benefit information, ensures appropriate and cost effective healthcare services to members. Assists Care Coordination staff in the identification, assessment, manag...
COMPANY DESCRIPTION Newport Academy is a gender-specific, comprehensive treatment program for adolescents suffering from mental health, behavioral health and substance abuse issues located in Litchfield County. The program combines the key elements essential in effectively treating adolescent girls and boys with substance abuse and other mental health disorders. As compared with adults, adolescen...
Mountain View Regional Hospital, the premiere surgical specialty hospital in Casper, Wyoming, and the Rocky Mountaint region, is looking for motivated, enthusiastic applicants wishing to be a part of our exceptional team. We are seraching for: Utilization Review RN / Dishcarge Planner (FT): Manages patients in the healthcare contiuum to achieve optimal clinical, financial, operational and patien...
Company: Yoh Utilization Review Nurse needed for a permanent opportunity with Yoh's client located in Santa Clara, CA. The Big Picture - Top Skills You Should 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 clin...
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...
Description The Utilization Review Nurse oversees the authorization process to ensure that the member receives benefits in accordance with their coverage in a quality and cost effective manner. The goals of this position are to authorize only covered services that are medically necesary to appropriate physicians/vendors in a timely manner. Qualifications CA RN or LVN license Minimum of 3 years...
Description The Utilization Review Nurse oversees the authorization process to ensure that the member receives benefits in accordance with their coverage in a quality and cost effective manner. The goals of this position are to authorize only covered services that are medically necesary to appropriate physicians/vendors in a timely manner. Qualifications CA RN or LVN license Minimum of 3 years...
What We Do: MCMC's success can be attributed to our diverse and talented work force.​ Our employees are the foundation of our business and are helping MCMC grow each year.​ Because of our tremendous growth, we are always in search of outstanding individuals.​ Workers Compensation Utilization Review Nurse SUMMARY: Responsible for performing workers compensation utilization review for multiple s...
Health Services for Children with Special Needs, Inc. in Washington, DC is currently seeking self-motivated candidates for a Utilization Review (UR) Nurse to focus on our inpatient members. The Utilization Review (UR) Nurse is responsible for the clinical review of pediatric and young adult members for all inpatient stays, homecare, outpatient rehabilitative therapy, durable medical equipment and ...
Henry Ford Health Dearborn, MI
Overview Our health system thrives on teamwork, and we know our employees achieve the greatest results when they are working together for a common goal - to provide care for our patients. If you enjoy working in a collaborative environment then we have a job for you! Henry Ford Health System is one of the country's largest health care systems and a national leader in clinical care, research and ...
eSPAN Healthcare, Inc. Appleton, WI
Job Description: UTILIZATION REVIEW NURSE - Registered Nurse, LVN or MSW Experience in Acute Hospital, Rehab or LTAC Desired We are searching for a Licensed Clinical Professional with Utilization Review and Case Management experience for our North Austin Specialty Hospital. Under the direction of the facility Administrator the Clinical Professional maintains the regulations, utilization and co...
Faith Regional Health Services Norfolk, NE, 68701
Respond to telephone and face-to-face inquiries seeking mental health care or information. Communicate all pertinent information about patients to psychiatrist or mid-level provider supervising patient admission. Coordinate patient admission from the Emergency department to the in-patients unit including all necessary communication to nursing unit staff. Document inquiry calls and related informat...
People want to be treated like individuals. At Cigna, we get that. That’s why we embrace and encourage peoples’ uniqueness, helping to give them the strength and confidence to show the world who they really are. The coverage, expertise and services we provide are at the very core of how we help people achieve their full potential – and ultimately, improve their health, well-being and sense of secu...
Henry Ford Hospital Dearborn, MI, 48120
Overview Our health system thrives on teamwork, and we know our employees achieve the greatest results when they are working together for a common goal - to provide care for our patients. If you enjoy working in a collaborative environment then we have a job for you! Henry Ford Health System is one of the country's largest health care systems and a national leader in clinical care, research and ...
Tenet Healthcare Corporation Lakewood, CA
Description : The Utilization Review Nurse oversees the authorization process to ensure that the member receives benefits in accordance with their coverage in a quality and cost effective manner. The goals of this position are to authorize only covered services that are medically necesary to appropriate physicians/vendors in a timely manner. Qualifications : CA RN or LVN license Minimum of 3...
Tenet Healthcare Corporation Lakewood, CA
Description : The Utilization Review Nurse oversees the authorization process to ensure that the member receives benefits in accordance with their coverage in a quality and cost effective manner. The goals of this position are to authorize only covered services that are medically necesary to appropriate physicians/vendors in a timely manner. Qualifications : CA RN or LVN license Minimum of 3...
Catholic Health Initiatives Lexington, KY
Utilization Review Nurse - SJH - FT - Days - 1400022844 Description Job Summary: Responsible for Utilization Review for medical necessity and level of care for patients accessing services at St. Joseph Hospital and St. Joseph East, though the application of InterQual Criteria and other resources as necessary. Determines correct patient status and obtains order from admitting physician. Cooperat...
LifeBridge Health Baltimore, MD
Opportunity to telecommute/work from home; full-time and part-time positions available. Utilization Review experience is required. Conducts chart review for clinical, financial and resource utilization information. Provides intervention and coordination for the plan of care to promote efficient use of resources, decrease denial of payment, and decrease length of stay. Requirements:Formal workin...

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