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200 Utilization Review Nurse jobs found on Monster.

Jobs 41 to 60 of 200
Kelly Services Tampa, FL
Description LPN / LVN / UTILIZATION REVIEW NURSE Kelly Healthcare Resources has an exciting LPN / LVN / Utilization Review Nurse opportunity available with our client located in Tampa, FL! As an LPN / LVN / Utilization Review Nurse with one of the largest health insurance benefits company in the nation, you will be responsible for working with various healthcare providers in order to help ensure...
Step 7 Clinton, MD
Utilization Review Nurse/Case Manager Our Client is seeking a qualified candidate with experience in Utilization Review and Case Manager. Our Client Our Client is an acute care hospital which serves more than 3,400 patients through its medical-surgical unit and sees nearly 45,000 patients through its emergency room each year. Requirements Qualified candidate must have current MD Nursing Lice...
Utilization Review Nurse needed for a direct hire 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 and MedicareWhat You'll Be Doing:- Day-to-day utilization review for inpatient and outpatient activities, utilizing approved policies, standards, and clinical criteria- Proac...
Description 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 ...
Health Choice Phoenix, AZ
Job Description Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire...
AIDS Healthcare Foundation Fort Lauderdale, FL
Responsibilities: Summary: Utilization Review is the process in which medical review determinations are made based on clinical guidelines and structured processes. This position reviews the utilization of the organization/plan's resources against established criteria, monitors and evaluates the medical necessity, appropriateness and efficient use of health care services. The position also provid...
Kelly Services Louisville, KY
Description RN - Utilization Review Nurse in Louisville, KY Kelly Healthcare Resources Work with the best in the industry. Every day, Kelly Healthcare Resources (KHR) specializes in providing highly skilled nursing and allied health professionals within hospitals and other health care facilities, as well as positions in sectors such as insurance, pharmaceutical, health management and education...
Medhealth Recruiting Hanover, MD
Description JOB SUMMARY The Utilization Review RN is responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical issues. Primary duties may include, but are not limited to: -Ensures medically appropriate, high quality, cost effective care through assessing...
Description 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 ...
Aerotek Phoenix, AZ
Start a new search >> Save it Upload Resume See all jobs at this company Printer-Friendly Version Save this job Email this job Utilization Review Nurse The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, genetic information or any other characteristic protected by l...
eQHealth Solutions Lombard, IL
Job Description We are a Quality Improvement Organization serving Illinois’ Medicaid population and are seeking a full time or part time Utilization Review Nurse. The successful candidate will render accurate first level utilization and quality review determinations based upon application of approved medical necessity criteria and quality screens. Job Requirements This candidate must have an ac...
Description 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 ...
Healthcare Employment Partners Clinton, MD
Utilization Review Nurse/Case Manager Our Client is seeking a qualified candidate with experience in Utilization Review and Case Manager. Our Client Our Client is an acute care hospital which serves more than 3,400 patients through its medical-surgical unit and sees nearly 45,000 patients through its emergency room each year. Requirements Qualified candidate must have current MD Nursing Lice...
Aerotek Phoenix, AZ
Start a new search >> Save it Upload Resume See all jobs at this company Printer-Friendly Version Save this job Email this job Utilization Review Nurse The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, genetic information or any other characteristic protected by l...
Riverside Health of Maryland, Inc. Baltimore, MD
Job Description Position Summary: The Utilization Review Nurse will support the clinical review operations needed to assist its membership. This position is a member of a team of nurses, physicians, pharmacists, and program coordinators. This role evaluates the efficiency, appropriateness, necessity of the use of medical services, procedures, and facilities. This position is empowered to review ...
Catholic Health Initiatives Lexington, KY
Job 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. Cooperates with outside vendor on Medicare/Medicaid Observati...
Kelly Services Woodland Hills, CA
Description LPN/LVN Utilization Review 5 month contract employment opporutnity with our large health insurance client based in their Woodland Hills office JOB DESCRIPTION:SUMMARY: Responsible for working with healthcare providers to help ensure appropriate and consistent administration of plan benefits through collecting clinical information to preauthorize services, assess medical necessity, ou...
Alaska Tribal Health System Sitka, AK
Position Summary: Performs utilization review at Mt. Edgecumbe Hospital in accordance with all state and federally mandated regulations. Baseline Qualification Requirements: *A Bachelor's Degree in Nursing; Five (5) years clinical care or nursing experienceOR an equivalent combination of education and experience AND two (2) years experience in Utilization Review *Five (5) years clinical care o...
Utilization Review Nurse needed for a contract opportunity with Yoh's client located in South San Francisco, CA. The Big Picture - Top Skills You Should Possess: - Utilization Management Experience - Knowledge of Medicare and Medi-Cal What You'll Be Doing: - Conduct on-site reviews at inpatient facilities, including acute care, and/or process authorization requests for various services includ...
Kelly Services Nashville, TN
Description Utilization Review Nurse 6 month contract opportunity with our large health insurance client based in their Nashville TN office SUMMARY: Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical issues. MAJOR JOB DUTIES AND RESPONSIBILITIES: ...

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