RN Utilization Review

Job DescriptionEmployment Type:Part timeShift:Description:Utilization Review RN, Case ManagementWhy Mount Carmel?              With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a...

Job Summary:As a Utilization Review RN at Trinity Health, you will play a critical role in ensuring that services are delivered in a manner that balances quality of care with efficiency, cost-containment, and compliance. This position requires a skilled and detail-oriented RN to conduct utilization management reviews for inpatient and outpatient cases,...

Job Summary:The RN Utilization Review Specialist ensures that services are delivered in a manner that balances quality of care with efficiency, cost-containment and compliance. This role conducts Utilization Management review for Inpatient and Outpatient cases, analyzes and summarizes medical utilization and medical chart audit results, and compares clinical...

Job Summary:We are seeking a skilled RN Utilization Review Specialist to join our team at Trinity Health. As a Utilization Review Nurse Case Manager, you will play a critical role in ensuring that services are delivered in a manner that balances quality of care with efficiency, cost-containment, and compliance.Key Responsibilities:Conduct thorough...

Employment Type:Part timeShift:Description:Utilization Review RN, Case ManagementWhy Mount Carmel?              With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in...

Job Title: Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. This role is critical in promoting safe and effective medication therapy, ensuring optimal patient outcomes.Key Responsibilities:Conduct comprehensive drug utilization reviews to identify potential...

Job Title: Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. This role is responsible for evaluating medication use patterns to promote safe and effective medication therapy, ensuring optimal patient outcomes.Key Responsibilities:Conduct comprehensive drug...

destinationone Consulting specializes in recruitment across diverse sectors including Healthcare Health Tech Government Municipalities NonProfits Legal Public Accounting Food and more. We are proactively building a data bank for opportunities in these fields. By applying you ensure our recruiters can quickly match you with suitable roles when they...

destinationone Consulting specializes in recruitment across diverse sectors including Healthcare Health Tech Government Municipalities NonProfits Legal Public Accounting Food and more. We are proactively building a data bank for opportunities in these fields. By applying you ensure our recruiters can quickly match you with suitable roles when they...

Job SummaryCVS Health is seeking a skilled Utilization Management Nurse Consultant to join our team. As a Utilization Management Nurse Consultant, you will play a critical role in ensuring that our members receive the appropriate care at the appropriate time and location.Key Responsibilities:Review services to ensure medical necessity and apply clinical...

About the RoleXsolis is seeking a skilled Nurse Coordinator to join our team in Appeals and Utilization Management. As a key member of our team, you will provide concurrent review and appeal support services for our growing client base.Key ResponsibilitiesProvide clinical reviews in accordance with Managed Care and CMS Regulatory RequirementsAssist with...

Job SummaryWe are seeking a highly skilled Loan Review Officer to join our team at WesBanco Bank Inc. This role will involve providing assistance for the independent and objective evaluation of the quality of the loan portfolio, the adequacy of loan documentation, and the effectiveness of loan administration functions.Key ResponsibilitiesAssist with the...

Job SummaryWe are seeking a skilled Clinical Authorization Review Nurse to join our team at the Ohio Department of Medicaid. As a Hybrid Clinical Authorization Review Nurse, you will be responsible for reviewing and authorizing medical services for Medicaid recipients. This is a full-time position with a competitive hourly rate of $31.86.Key...

Evolent Health seeks a skilled Cardiology Physician Clinical Reviewer to join our team. As a key member of our utilization management team, you will play a critical role in ensuring patients receive the best possible care.Key Responsibilities:Serve as the specialty match reviewer in Cardiology cases that do not initially meet the applicable medical necessity...

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Welcome to Welty Energy, a professional services company specializing in program and project management, transmission line engineering, and substation engineering. As an Assistant Project Manager, you will play a key role in delivering projects to completion on time and on budget while maintaining a high level of customer centricity.Key Responsibilities:Lead...

About the RoleThe HVAC Utilities Technician is responsible for the overall preventative, predictive and corrective maintenance strategies of utility systems and equipment in accordance with the OEM recommendations and internal SOPs.This role involves monitoring and responding to equipment and systems tied to the Building Management/Controls and Monitoring...

Job Summary:As a Main Line Utilities Foreman at Thompson Concrete/Excavation, you will oversee the work of staff to ensure production goals are met. This role requires strong leadership and problem-solving skills, as well as the ability to effectively communicate with crew members and clients.Duties/Responsibilities: Follows company values, vision, and...

Title: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an...

Title: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an...