Utilization Review Coordinator

Job SummaryWe are seeking a skilled RN to join our Utilization Review team as a Per Diem Case Manager. In this role, you will play a critical part in ensuring that patients receive the most appropriate and cost-effective care.Key ResponsibilitiesConduct thorough assessments of patient needs and develop comprehensive care plansCollaborate with healthcare...

Per Diem Case Manager OpportunityWe are seeking a skilled RN to join our Utilization Review team as a Per Diem Case Manager. In this role, you will play a critical part in ensuring that patients receive the most appropriate and cost-effective care.Key ResponsibilitiesConduct thorough assessments of patient needs and develop comprehensive care...

Job SummaryWe are seeking a skilled RN to join our Utilization Review team as a Per Diem Case Manager. In this role, you will play a critical part in ensuring that patients receive the highest quality care while also managing the insurance authorization process.Key ResponsibilitiesConduct thorough assessments of patient needs and develop comprehensive care...

DescriptionPOSITIONSUMMARY:  Registered Nurse uses approvedscreening criteria (MCG®/CMS Inpatient List) to determine themedical necessity of a requested hospitalization and theappropriate level of care for that patient. Actively involved inthe continued management of patient status/LOC. Providesconsultative role as utilization management nurse to clinical...

DescriptionPOSITION SUMMARY:  Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in the continued management of patient status/LOC. Provides consultative role as utilization management nurse to...

DescriptionPOSITION SUMMARY:  Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Actively involved in the continued management of patient status/LOC. Provides consultative role as utilization management nurse to...

Overview: The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission. Responsibilities: Job Summary Utilization Review, Utilization Management, Advocacy and Education Clinical Analysis and Data Management Clinical Care...

Overview: The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission. Responsibilities: Job SummaryUtilization Review, Utilization Management, Advocacy and EducationClinical Analysis and Data ManagementClinical Care...

Job SummaryUF Health-Central Florida is seeking a skilled Utilization Review Nurse to join our team. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate use of hospital resources and medical services.ResponsibilitiesDetermine the medical necessity of hospital admissions and continued staysFacilitate timely...

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...

Details Department: Case Management Schedule: Full-Time, Monday-Friday (8:00A - 4:30P) Hospital: Ascension St Thomas Location: Nashville, TN - - - ****TN Nursing License is REQUIREDBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee...

Employment Type:Full timeShift:Description:*** This position is located at the Westmont office***Join our small but mighty team to guide and manage Utilization Review and Management for the Loyola Physician Partners LPP) Health Plan, a delegated entity for BCBS HMO Medicare and Commercial  coverage. Experience with mcg or  Interqual and Epic EMR are...

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Trinity Health. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary costs.Key ResponsibilitiesReview hospital admissions to determine medical necessity and ensure...

Job SummaryThis position is a key role in the preparation and presentation of evidence and analyses in cases before the New Mexico Public Regulation Commission.Key ResponsibilitiesPresentation of written and oral testimony as evidence, as well as cross-examination as an expert witness in a quasi-judicial setting.Preparation of responses to interrogatories...

Details Department: Case ManagementSchedule: Full-Time, Monday-Friday (8:00A - 4:30P)Hospital: Ascension St ThomasLocation: Nashville, TN ****TN Nursing License is REQUIREDBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance...

Job SummaryThe Utilization Review Nurse is a key member of our team, responsible for ensuring the highest quality patient care while optimizing resource utilization. This role requires a strong clinical background, excellent communication skills, and the ability to work collaboratively with various stakeholders.Key ResponsibilitiesConduct thorough reviews of...

Job SummaryThe State of New Mexico is seeking a highly skilled Public Utilities Economist to join our team in the Economics Bureau. As a key member of our team, you will play a crucial role in the preparation and presentation of evidence and analyses in cases before the New Mexico Public Regulation Commission.Key Responsibilities* Presentation of written and...

Job Title: RN Utilization Review SpecialistSouth Central Health System is seeking a highly skilled RN Utilization Review Specialist to join our team. As a key member of our Medical Staff Office, you will play a critical role in ensuring the quality and safety of patient care.Responsibilities:Collect and prepare data from medical records for OPPE and FPPE...

Job Summary:The Utilization Coordinator is a key member of the Diverse Lynx team, responsible for coordinating admissions, performing concurrent and retrospective utilization review, and facilitating discharge planning. This role requires strong clinical knowledge and excellent communication skills to ensure seamless coordination of care.Key...

Job Summary:The Utilization Coordinator at Diverse Lynx is responsible for coordinating admissions, performing concurrent and retrospective utilization review, and facilitating discharge planning. This role requires strong clinical knowledge and excellent communication skills to ensure seamless transitions for patients.Key Responsibilities: Coordinate...