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569 Utilization Review Nurse jobs found on Monster.

Jobs 41 to 60 of 569
The San Francisco Health Plan (SFHP) is a progressive public health plan providing affordable coverage to low income families residing in San Francisco. We are also the third party administrator for the innovative universal healthcare project, Healthy San Francisco. SFHP was designed for and by the residents it serves – many of whom would not otherwise be able to obtain healthcare. SFHP is dedicat...
The San Francisco Health Plan (SFHP) is a progressive public health plan providing affordable coverage to low income families residing in San Francisco. We are also the third party administrator for the innovative universal healthcare project, Healthy San Francisco. SFHP was designed for and by the residents it serves – many of whom would not otherwise be able to obtain healthcare. SFHP is dedicat...
Description: Be a part of our growing team! No nights or on-call! This is an office based position and all candidates must be able to work occasional Saturdays based on business need. Hours will either be 8:00 am to 5:00 pm or 9:00 pm to 6:00 pm The Utilization Management Nurse is responsible for reviewing proposed hospitalization, home care, and inpatient/outpatient treatment plans for medical ne...
Remote - Work From Home
Mitchell International, Inc. is a leading provider of information and workflow solutions to the Property & Casualty Claims and Automotive Collision Repair industries. Founded in 1946, Mitchell has delivered advanced information and technology solutions to over 100,000 customers throughout North America, helping them to improve their business process performance. The company's comprehensive solutio...
EXCELLENT OPPORTUNITY for stellar Case Managers West of Chicago working with a well-established organization. This role is telephonic and would be reviewing medical necessity and appropriate level of care. In this role as a Case Manager, you will also perform utilization management technical activities as assigned within the productivity standards set for performance. Keys to success in this Case...
Are you an RN looking seeking a position in an office environment that is fast paced and rewarding? Do you have experience with Interqual or Milliman criteria, and looking to apply this knowledge to a position? If so, this position is for you! WHAT WE LOOK FOR: Active RN license in the state of IL Experience in Case Management/Utilization Management Ability to use Microsoft office and other comput...
EXCELLENT OPPORTUNITY for stellar Case Managers West of Chicago working with a well-established organization. This role is telephonic and would be reviewing medical necessity and appropriate level of care. In this role as a Case Manager, you will also perform utilization management technical activities as assigned within the productivity standards set for performance. Keys to success in this Case...
CONTRACT TO HIRE OPPORTUNITY for stellar Case Managers West of Chicago area working with a well-established organization. This role is telephonic and would be reviewing medical necessity and appropriate level of care. In this role as a Case Manager, you will also perform utilization management technical activities as assigned within the productivity standards set for performance. Keys to success i...
Utilization Review RN - Managed Care San Francisco, CA Job Summary: The Utilization Management Nurse is responsible for utilization management, utilization review, or concurrent review (telephonic inpatient care management). The UM Nurse will performs reviews of current inpatient services, and determine medical appropriateness of inpatient and outpatient services following evaluation of medical gu...
CONTRACT Concurrent Review / Utilization Management RN – Managed Care South Seattle, WA * This is a Full Time, Benefits Available, CONTRACT position expected to last around 1-2 months! * Job Summary: As a Concurrent Review/UM 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 f...
CALLING ALL UTILIZATION REVIEW CASE MANAGERS! Are you interested in working for a Hospital recognized by employees as one of the leading non-profit organizations in Detroit? Do you want to put your skills to use in a dynamic healthcare environment? This fast paced, professional, progressive acute and emergency Hospital is continuing to elevate above Michigan facilities in various fields of acute a...
Concurrent Review / Utilization Management RN – Managed Care South Seattle, WA Job Summary: As a Concurrent Review/UM 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 telepho...
RN - MANAGER - UTILIZATION REVIEW - RN RN - MANAGER - UTILIZATION REVIEW - RN Excellent opportunity for an experienced Utilization Review manager or Case Management manager in Charlotte, NC. The Manager of Utilization Review is responsible for oversight and management, operations and ongoing quality, productivity and efficiency for utilization review processes. Responsible for maintaining appropri...
At Texas General Hospital we provide the highest Quality of Medical Care to the community and an excellent opportunity for professional growth and training for our Medical Staff. Quality Patient Care and Patient Satisfaction are our top priorities. Physicians on staff have trained at prestigious institutions such as Harvard, Yale, Emory, University of Texas Southwestern and Baylor. These physician...
Job Location Name Sinai-Grace Hospital Job Description Under limited direction and according to established policies and procedures, responsible for collaborating with physicians and applying medical necessity criteria (severity of illness and intensity of service) to determine appropriate level of care (inpatient, outpatient, observation, or community) at all points of entry. Access location poin...
Montevista Behavioral Health Hospital is a 90-bed, privately owned psychiatric hospital providing a full continuum of care for all ages. The hospital was established in 1985 and has been essential in providing behavioral health services to the residents of Southern Nevada for the past 25 years. The medical staff is composed of psychiatrists, addictionologists, family practitioners, internists, ane...
Job Location Name Orchestra Place - Det Med Ctr Job Description Utilization Review Specialist-4NG54 Under limited direction and according to established policies and procedures, responsible for collaborating with physicians and applying medical necessity criteria (severity of illness and intensity of service) to determine appropriate level of care (inpatient, outpatient, observation, or community)...
Job Location Name Orchestra Place - Det Med Ctr Job Description Utilization Review Specialist-4NG54 Under limited direction and according to established policies and procedures, responsible for collaborating with physicians and applying medical necessity criteria (severity of illness and intensity of service) to determine appropriate level of care (inpatient, outpatient, observation, or community)...
Position Description: We are currently seeking a Utilization Review Supervisor for our Anaheim, CA location. This is a Work From Home position, but candidate must have flexibility to report into the office. Main responsibilities will include but are not limited to: • Responsible for the ongoing training, supervision and evaluation of professional staff performing Utilization Review services, inc...
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