Utilization Review Nurse Jobs

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123 Utilization Review Nurse jobs found on Monster.

Jobs 1 to 20 of 123
Our client in South San Francisco is looking for a Utilization Review Nurse to join their team! Duties · Conduct on-site reviews at inpatient facilities, including acute care, and/or process authorization requests for various services including but not limited to: outpatient, rehabilitation and/or home health services. · Review authorization requests for out-of-network inpatient facilities. · ...
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 ...
Floyd Memorial Hospital New Albany, IN
- Graduate of an Approved Nursing Program - Licensure Required - Experience is required Seeking Home Care Quality Improvement/Utilization Review RN! Home Health Care Southern Indiana/Louisville, Kentucky area Floyd Memorial Hospital In this role, you will provide skilled nursing care in a community setting, including health maintenance, rehabilitation, and health promotion utilizing the nursing...
Berkshire Hathaway Homestate Companies Omaha, NE, 68102
Utilization Review Nurse Are you looking for an opportunity to leverage your experience and increase your impact? Are you tired of hospital politics or working swing shifts and weekends? Berkshire Hathaway Homestate Companies has an immediate opportunity for experienced nurses with independent and critical thinking skills who are interested in helping injured workers get the care they need. As a...
Maxim Staffing Solutions’ is seeking experienced Psych Registered Nurses for multiple Utilization Review openings in the Chicago land area. These are full-time permanent positions with great benefits and competitive pay. The ideal candidates MUST have minimum of 3 plus years of RN experience with a background in PSYCH and/or substance abuse healthcare setting, including Utilization review experien...
IASIS Healthcare LLC Phoenix, AZ
Qualifications High School Diploma or GED Associate's Degree or Bachelor's degree from an accredited Nursing School Previous UR/Discharge planning experience preferred Chart review experience helpful Previous Medicaid/Medicare experience preferred...
Fairview Health Services Minneapolis, MN, 55415
Join our team in providing and supporting exceptional care. Fairview Health Services is an award-winning nonprofit health care system with more than 21,000 employees and 2,300 aligned physicians. Based in Minneapolis, we provide exceptional, coordinated health care—from preventing illness and injury to caring for the most complex medical conditions. Passionate, innovative, talented employees are ...
Health Net, Inc. is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. The company provides health benefits to approximately 6.0 million individuals across the country through group, individual, Medicare (including the Medicare pres...
Tenet Healthcare Corporation Dallas, TX
Description : As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient c...
Tenet Healthcare Corporation Phoenix, AZ
Description : As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 600 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient c...
MountainView Hospital
Schedule: Full-time Description TriStar Centennial Medical Center – Nashville, TN Clinical Review Nurse – Quality/Risk Management Our 657 bed hospital is both nationally and locally recognized, including being named as one of the nation's Top 100 Hospitals in the areas of cardiology, stroke, orthopaedics and breast cancer management. As a result of the continued advances in quality care, many ...
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...
Seattle Children's Hospital Seattle, WA, 98113
Responsible for fulfilling Hospital Utilization Management policies and procedures by performing review of scheduled or unscheduled patient admissions, from admit date through discharge, for appropriate level of care classification. Applies knowledge of nationally recognized admission criteria, (InterQual and Milliman Care Guidelines) SCH hospital guidelines of care, standard clinical pathways and...
IASIS Healthcare Phoenix, AZ, 85002
The Utilization Review Nurse completes inpatient admission and concurrent reviews for Health Choice members, considering Interqual criteria and other national standards, policy and procedures and the members's medical benefits. Reviews are made on-site, telephonically, and via fax. Assist and coordinates the discharge planning needs of the member with the facility staff, attending physician, the m...
Humana Inc. Louisville, KY
Utilization Review Nurse (RN) - Louisville, KY Requisition ID 127559 Business Overview Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explor...
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...
LifeBridge Health Baltimore, MD
*LI- SH *TMJ 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: Must have knowledge of Utilization Review (UR) rules and regulations; knowledge of Conditions of Participation; Minimum three year...
UnitedHealth Group Inc Brentwood, TN
Position Description There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work. (sm) Position will be office based out of our Brentwood, Memphis or Knoxville of...
Los Angeles County Department of Health Services Los Angeles, CA, 90009
Job details Job 1 of 1 Apply to job   Send to friend Save to cart View similar jobs Bulletin Number 27254BR Type of Recruitment Open Competitive Job Opportunity Department Health Services Position Title UTILIZATION REVIEW NURSE SUPERVISOR I Exam Number Y5125J Filing Type Open Continuous Filing Start Date 10/11/2013 Salary Type Monthly Salary Minimum 6444.98 Salary Maximum 9389.12 Benefits Info...

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