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556 Utilization Review Nurse jobs found on Monster.

Jobs 41 to 60 of 556
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 (Nashville) or Memphis office loca...
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 (Nashville) or Memphis office loca...
Description: Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is servi...
Description: WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella. Do you have compassion and a p...
Sterling Medical Corp is seeking a Clinical Nurse (RN) Utilization Management to provide services on Hurlburt Field AFB, FL. Clinical Nurse (RN) - Utilization Management Needed!!! Qualifications Education: Shall be a graduate from an associate (ADN) or baccalaureate (BSN) degree program in nursing accredited by a national nursing accrediting agency recognized by the US Department of Education. Lic...
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. We are committed to universal coverage, excellent healthcare quality and access, exemplary service, and supporting the financial viab...
Requirements: Active Oklahoma RN License 2+ years experience performing utilization or concurrent review 2+ years experience with developmental disability patient population (autism, muscular dystrophy, tourette syndrome, cerebral palsy, etc) Experience communicating with patients or providers over the telephone ( triage, UR, case management, etc ) Responsibilities: The Registered Nurse will commu...
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) Utilization Management Nurse responsibilities include: * Perform utilization managemen...
Working At Aetna - the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways. Candidates can be located in either Charlotte, NC or Morrisville, NC. The Utilization Management RN use...
Working At Aetna - the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways. Candidates can be located in either Charlotte, NC or Morrisville, NC. The Utilization Management RN use...
Description The Case Manager will assess admission necessity utilizing the IQ SI/IS criteria. Review date will be assigned. If treatment plan does not meet criteria, the UR nurse will refer case to attending physician. If no determination, the UR nurse will refer the case to the Medical Director. The Case Manager will perform the initial IQ and clinical review, within one working day of admission...
Description The Case Manager will assess admission necessity utilizing the IQ SI/IS criteria. Review date will be assigned. If treatment plan does not meet criteria, the UR nurse will refer case to attending physician. If no determination, the UR nurse will refer the case to the Medical Director. The Case Manager will perform the initial IQ and clinical review, within one working day of admission...
Working At Aetna - the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways. This position requires local travel to selected hospitals for the purpose of onsite concurrent review o...
Description The Case Manager will assess admission necessity utilizing the IQ SI/IS criteria. Review date will be assigned. If treatment plan does not meet criteria, the UR nurse will refer case to attending physician. If no determination, the UR nurse will refer the case to the Medical Director. The Case Manager will perform the initial IQ and clinical review, within one working day of admission...
Description The Case Manager will assess admission necessity utilizing the IQ SI/IS criteria. Review date will be assigned. If treatment plan does not meet criteria, the UR nurse will refer case to attending physician. If no determination, the UR nurse will refer the case to the Medical Director. The Case Manager will perform the initial IQ and clinical review, within one working day of admission...
Case Manager Registered Nurse (RN) Full Time, 40 Hours Per Week About the Job: Concurrent review and analysis of inpatient records to determine if the patient's admission and continued hospital stay triggers any pre-defined quality indicators. Utilization review including assessment of medical records for appropriateness, level of care provided. Assess utilization of treatment, modalities, medicat...
The Utilization Management Registered Nurse provides Referral Management (RM) activities include timely processing of Right of First Refusal (ROFR) requests, screening of specialty care referrals, sustaining up-to-date Specialty Clinic Booking Guidance, MTF Capabilities Report, ROFR Reports, maintaining up-to-date MTF/Managed Care Support Contract (MCSC) Memorandums of Understanding (MOUs), comply...
Working At Aetna - the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways. This position requires local travel to selected hospitals for the purpose of onsite concurrent review o...
Mediscan is currently looking to hire a Utilization Review/InterQual Specialist. This is an excellent opportunity for a motivated, and experienced Case Manager who is looking to work full time. The assignment is for 8 weeks with an opportunity to extend. Please see minimum requirement below. Minimum Qualifications: •A minimum of 2 years of recent Utilization Review/ InterQual experience in Acute C...
Position Summary: To conduct continued stay reviews of medical record documentation using pre-established criteria and to provide updated progress reports to third party payers in order to receive certification for payment. Coordinates quality improvement activities and directs the work of Utilization Management Coordinators. Summary of Essential Position Functions: . Maintains work logs of all re...

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Healthcare Career Tools

Nurse Manager

Salaries

$53,040.00 - $103,400.00
Typical Salary for Nurse Manager
(311 Respondents)
Source: Monster.com Careerbenchmarking Tool

Education / Training

Bachelor's
40.9%
Master's
30.7%
Associates
22.8%
(215 Respondents)
Source: Monster.com Careerbenchmarking Tool

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