Utilization Review Nurse

TITLE: UM/Appeals RN **5 of the 10 nurses MUST HAVE their Legal Nurse Consultant Certificate (LCN)***LOCATION: Hybrid; New Hyde Park, NY 11042 (preference is for someone to be local to Long Island and able to come into the office. If in NY and not local to Long Island, nurses can work remotely)Looking for 10 RNs to do appeals work under the team handling on...

Job DescriptionJob DescriptionRN- Utilization Review Nurse LTSS/DME*Full Time 100% Remote Opportunity*COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGECARE!VillageCare is looking for a self-motivated and passionate RN as Utilization Review Nurse for a Full-Time position. This is an exciting and dynamic position from the comfort of your own home...

The Utilization Review Nurse performs prospective and retrospective reviews for post-acute care services. The purpose and goal of utilization management is to assure that Wellsky’s population receives medically necessary services in the appropriate setting, with the appropriate provider, and at the appropriate level of care. This position is responsible...

The Utilization Review Nurse performs prospective and retrospective reviews for post-acute care services. The purpose and goal of utilization management is to assure that Wellsky’s population receives medically necessary services in the appropriate setting, with the appropriate provider, and at the appropriate level of care. This position is responsible...

The Utilization Review Nurse performs prospective and retrospective reviews for post-acute care services. The purpose and goal of utilization management is to assure that Wellsky’s population receives medically necessary services in the appropriate setting, with the appropriate provider, and at the appropriate level of care. This position is responsible...

JOB TITLE (#25009): Maternal Nurse Reviewer / Contract - Metropolitan Area Minimum of 4 years clinical practice experience in a facility or community-based setting Greenlife Healthcare Staffing is currently seeking a Maternal Nurse Reviewer to fill an opening with a Non-profit organization located in New York Requirements of the Maternal Nurse...

VNS Health is seeking a Clinical Utilization Review Nurse for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff We are looking for a detail-oriented and experienced Clinical Utilization Review Nurse to join our team. The successful...

The Utilization Review Nurse performs prospective and retrospective reviews for post-acute care services. The purpose and goal of utilization management is to assure that Wellsky’s population receives medically necessary services in the appropriate setting, with the appropriate provider, and at the appropriate level of care. This position is responsible...

Utilization Review Registered Nurse Coordinate patient care with multidisciplinary team for quality and cost-effective care Conduct initial and ongoing assessments and determine and manage outcomes Assist with discharge planning and provide patient/family education Collaborate with other departments and community health care agencies for effective and...

Job DescriptionJob DescriptionDescription:Zinnia Health is a fast-growing integrated healthcare company. We value our employees and care for our clients. Do you have unique talents that you would like to share with others? We would love to have you join our team!Competitive PayCareer DevelopmentCompetitive Benefits & 401kValues: Integrity, Teamplay, 1%...

Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review Physician is the lead clinician for the health plan. Responsible for the administration of medical services for company health plan utilizing the evidence-based medical...

Job DescriptionJob DescriptionUtilization Review Case ManagerThe UR Case Manager will complete prior authorizations and concurrent reviews for new admissions or existing patients. The UR Case Manger will work with insurance companies and the clinical team, reviewing documentation to determine medical necessity criteria and length of...

Job Description:Summary:This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and...

43 New Scotland Avenue Albany, NY 12208Department/Unit:Care Management/Social WorkWork Shift:Day (United States of America)Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients.Salary Range: $31.28 - $51.61 per hour• Completes Utilization Management and Quality Screening for assigned patients.• Applies MCG...

Job DescriptionJob DescriptionSummaryMaverick is seeking a Utility Pole Inspector to support our growing field engineering team. The ideal candidate will have a strong background in field survey and data collection, particularly in the art and science of wood pole inspection and treatment. The role will comprise of daily interactions with the engineering...

Job DescriptionJob DescriptionSummaryThe Utility Worker will aid skilled tradespeople in various construction projects to ensure the efficient functioning of infrastructure to meet the operational needs of the customer. The position requires physical strength, stamina, flexibility, and the ability to work in different weather conditions. This operates under...

VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Cliffside Park, New Jersey. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Leads interdepartmental quality improvement activities such as development and engagement, clinical review,...

VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Cliffside Park, New Jersey.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: ASAPDuration: OngoingEmployment Type: StaffLeads interdepartmental quality improvement activities such as development and engagement, clinical review, clinical...

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Cliffside Park, New Jersey. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product...

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Cliffside Park, New Jersey. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product...