Utilization Review Nurse

Job Description About CarolinaEast Medical Center CarolinaEast Health System is dedicated to quality and compassionate care across the Coastal Carolina region. The flagship of the health system is a 350 bed full service medical center housing a complete complement of inpatient and outpatient services with the latest technology. CarolinaEast Health System...

Job Description About CarolinaEast Health System CarolinaEast Health System is dedicated to quality and compassionate care across the Coastal Carolina region. The flagship of the health system is a 350 bed full service medical center housing a complete complement of inpatient and outpatient services with the latest technology. CarolinaEast Health System...

Job DescriptionAbout CarolinaEast Medical Center CarolinaEast Health System is dedicated to quality and compassionate care across the Coastal Carolina region. The flagship of the health system is a 350 bed full service medical center housing a complete complement of inpatient and outpatient services with the latest technology. CarolinaEast Health System...

Job Description Job Summary: Under the direction of the Utilization Review Manager and Physician Advisor, the Utilization Review Registered Nurse (UR-RN) assists in administration of utilization review functions. The UR RN will validate the documentation contained in the medical record. The UR RN will apply utilization review criteria, clinical...

Job DescriptionJob Summary: Under the direction of the Utilization Review Manager and Physician Advisor, the Utilization Review Registered Nurse (UR-RN) assists in administration of utilization review functions. The UR RN will validate the documentation contained in the medical record. The UR RN will apply utilization review criteria, clinical...

Job Summary:SUNY Downstate Health Sciences University's Department of Care Management is seeking an experienced Utilization Review Nurse Specialist to support the review and management of patient care services.Key Responsibilities:* Complete and send initial clinical reviews within 48 hours of admission to payors via Care Management Module, CarePort.*...

About the RoleThe Nurse Case Manager - Utilization Review position at SUNY Downstate Health Sciences University offers an exciting opportunity for a seasoned Nurse to leverage their expertise in case management and utilization review to improve patient outcomes.This role requires a strong background in nursing and case management, as well as excellent...

Job DescriptionAbout CarolinaEast Medical CenterCarolinaEast Health System is dedicated to quality and compassionate care across the Coastal Carolina region. The flagship of the health system is a 350 bed full service medical center housing a complete complement of inpatient and outpatient services with the latest technology. CarolinaEast Health System...

RN- Utilization Review Nurse Inpatient * Full Time - 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! 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 as you will be...

RN- Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! 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 as you will be...

Job Description: Title: Care Manager - ED Shift: 9am-5pm Hybrid (40 hours weekly) Location: New York, NY 10037 Duration: 13 Weeks (Possible Extension) Pay: $52/hr. Job Summary: • Review and evaluate the assessment and UAS information for members in the MLTC and MAP lines of business. • Develop a working relationship with the PCP to be able to...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Hours: 8:30am-5pm EST; Monday-Friday** **Must have a New York State license...

We are seeking an experienced Medical Professional to join our team as a Utilization Review nurse in Manhattan, Kansas.Job Summary:Voca is a leading healthcare staffing agency that offers travel nursing opportunities to skilled professionals. As a Utilization Review nurse with Voca, you will have the opportunity to work with top healthcare organizations and...

OverviewAt MJHS, we are dedicated to providing exceptional healthcare services to our patients and members. Our team of professionals works collaboratively to ensure that our health plans meet the needs of our diverse population.In this role as a Managed Care Nurse - Utilization Review Specialist, you will play a critical part in reviewing cases and...

Job DescriptionTitle: Care Manager - EDShift: 9am-5pm Hybrid (40 hours weekly)Location: New York, NY 10037Duration: 13 Weeks (Possible Extension)Pay: $52/hr. Job Summary:• Review and evaluate the assessment and UAS information for members in the MLTC and MAP lines of business. • Develop a working relationship with the PCP to be able to contact and...

Your expertise can shape the future of healthcare as a Utilization Review Clinician on our Medical Management team. We're a national organization dedicated to delivering high-quality services.This is a remote opportunity for US-based clinicians with independent licensure. Preference is given to those in the central or eastern time zones with experience in...

**Job Title:** Utilization Review CoordinatorEstimated Salary: $63,400 (based on NYC location and industry standards)At New York State Office of Mental Health, we are seeking a highly skilled Utilization Review Coordinator to join our team. As a key member of our clinical quality team, you will be responsible for reviewing medical records and analyzing data...

Job Summary:The Healthcare Utilization Analyst RN is responsible for ensuring high-quality, cost-effective medical outcomes through utilization review and management. This role involves monitoring patient charts and the utilization of healthcare services. Collaborating with physicians, Care Coordinators, Social Workers, and other members of the...

Hospitals on Incredible Health are actively hiring and accepting applications in the Charlottesville, VA area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night...

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve...and for each other. Come join us! It's the way you want to be treated. Position Summary: Performs medical record review for severity of illness and intensity of...