Utilization Review Nurse Jobs

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1000+ Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 28978
HC198315: Spectrum Review Services, Inc. 1824 Sawdust Road, Building #2 Spring Tx 77380 Woodlands area healthcare company has an immediate full-time opening for RN/LVN. Some UR experience helpful, but will consider training the right person. The right person must be computer literate with strong communication and organizational skills. Email resume to ***** or fax to (281) 29...
Utilization Review Nurse (RN or LPN) – Managed Care South Seattle, WA Job Summary: As a Utilization Review Nurse you will utilize your clinical skills to review and monitor members’ utilization of health care services with the goal of maintaining high quality cost-effective care for health plan members that are hospitalized in acute, skilled and long term care settings. You will telephonically ...
Utilization Review Nurse Kelly Services has an exciting opportunity available for a UTILIZATION REVIEW NURSE to come work with our client located in Minnetonka, MN. As the Utilization Review Nurse, you’ll work behind the scenes to maximize cost efficiency and quality of various health care services. Through reviews and audits, you’ll ensure that patients receive care they need without burdening h...
Utilization Review Nurse/Case Manager (LPN or RN) - 3+ month contract opportunity with our large health insurance client on Spring Garden! Kelly Services has an exciting opportunity available for a Utilization Review Nurse, come work with our client located in Philadelphia, PA. As the UR Nurse, you’ll work behind the scenes to maximize cost efficiency and quality of various health care services. ...
RN / CASE MANAGER / UTILIZATION REVIEW NURSE Kelly Healthcare Resources has an urgent need for a contract RN / Case Manager / Utilization Review Nurse to come and join our client located in Nashville, TN! As the RN / Case Manager / Utilization Review Nurse with a global health insurance service company, you’ll be responsible for utilizing established screening criteria to identify cases which req...
Maxim Staffing Solutions is looking to bring on RN's for several full time contracts in Utilization Review. These are 13 week contracts and possible travel contract. We are looking for nurses with exceptional clinical skills, positive attitude, a strong work ethic, and who are team players. Our office stresses the importance of these qualities, and we are only looking to bring on the best nurses a...
Maxim Staffing Solutions is looking to bring on RN's for full time Utilization Review work. We are looking for nurses with exceptional clinical skills, positive attitude, a strong work ethic, and who are team players. Our office stresses the importance of these qualities, and we are only looking to bring on the best nurses. The Registered Nurse, as a professional practitioner employed by Maxim He...
Facility Information: Since 1976 Lakeside Behavioral Health System has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and mid-south region. The 319 bed facility is located on a safe and private 37 acre campus in northeast Shelby County and provides comprehensive behavioral health treatment for adults, seniors, adolescents and children. Lak...
Facility Information: Since 1976 Lakeside Behavioral Health System has been the premier provider of specialized behavioral health and addictive disease services in the Memphis and mid-south region. The 319 bed facility is located on a safe and private 37 acre campus in northeast Shelby County and provides comprehensive behavioral health treatment for adults, seniors, adolescents and children. Lak...
MHM Services is proud to announce we have been awarded a contract with the VT Department of Corrections to provide healthcare and mental health services to inmates throughout the state. We are currently seeking a Utilization Review Nurse to join our team in our VT. This is a FT position, based in our Waterbury, VT office. The UR/UM Nurse performs review of requests for prior authorization of medi...
Position Summary: Enhances continuity of patient care by providing liaison between assigned populations, providers, hospitals, and physicians through the processing of medical determinations. To review, coordinate and facilitate all necessary information required from the provider in order to render an informed determination on medically reasonable, necessary and appropriate clinical care. Roles...
Position Summary: Enhances continuity of patient care by providing liaison between assigned populations, providers, hospitals, and physicians through the processing of medical determinations. To review, coordinate and facilitate all necessary information required from the provider in order to render an informed determination on medically reasonable, necessary and appropriate clinical care. Roles...
We are recruiting RNs with case management, utilization review and/or Inter Qual experience to work on-going assignments at a regional health care provider. Assignments range in length, Monday-Fridays, usual hours are 8am-5pm. Job location in Metairie as well as New Orleans. Applicant must have active Louisiana RN license and experience in case management and/or utilization review....
Judge Healthcare is actively seeking a full time utilization review registered nurse for one of Las Vegas fastest growing healthcare facilities! The right candidate must possess the following qualifications: Active RN licence in the state of Nevada. 3 years of clinical experience in acute care setting Relevant previous experience in utilization review. BSN Preferred. Please send your MOST UP...
RN / CASE MANAGER / UTILIZATION REVIEW NURSE / SENIOR SPECIALIST Kelly Healthcare Resources has an urgent need for a contract RN / Case Manager / Utilization Review Nurse/ Senior Specialist to come and join our client located in Nashville, TN! As the RN / Case Manager / Utilization Review Nurse with a global health insurance service company, you’ll be responsible for utilizing established screeni...
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...
Position Summary: This position is responsible for all Utilization Management functions required by the IPA's and the contracted health plans. Assures that authorizations are processed to meet health plan and NCQA time-frames. Qualifications: Minimum requirements include: Current RN license in the State of California Excellent communication skills Must be a self-starter Knowledge of HMO req...
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...
What Is Done On This Job: Perform prospective and retrospective medical review and preauthorization of selected procedures utilizing InterQual criteria. Record and report managed care activities including overutilization or quality of care issues. Perform concurrent review of selected services. Interpret complex medical and surgical care. Assist in development and ongoing revision of managed ...
Utilization Review Nurse - LPN Kelly Services has an exciting opportunity available for a Utilization Review Nurse - LPN to come work with our client located in Oklahoma City, OK. As the Utilization Review Nurse- LPN, you'll work behind the scenes to maximize cost efficiency and quality of various health care services. Within the scope of practice, responds to calls, conducts certification review...

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Healthcare Career Tools

Nurse Manager

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Bachelor's
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Master's
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Associates
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Source: Monster.com Careerbenchmarking Tool

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