Utilization Review Nurse

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...

Job SummaryNew York State Psychiatric Institute is seeking a Utilization Review Coordinator to analyze and evaluate the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Candidates from outside or within State Service can apply for this position under the Hiring for Emergency...

Job Summary:The Utilization Review Nurse will ensure appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with health plans and different providers/care teams to help ensure inpatient bed days and associated discharge/transitional care plans are...

Job Description: Seeking Utilization Management RN! Full-time, days Baptist Health Floyd, Case Mangement Southern Indiana/Louisville, Kentucky area The Utilization Management Nurse completes utilization review on all assigned patients. He/she conducts review of admissions, length of stay, discharge, and services ordered and provided on a concurrent and...

Job Description:Seeking Utilization Management RN!Full-time, days Baptist Health Floyd, Case MangementSouthern Indiana/Louisville, Kentucky area The Utilization Management Nurse completes utilization review on all assigned patients. He/she conducts review of admissions, length of stay, discharge, and services ordered and provided on a concurrent and...

Empower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...

Dane Street is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized evidence-based guidelines, and client-specific...

Job DescriptionClinical Document-Coding MgmtSaint Peter's is the 5th hospital worldwide to earn Magnet status SIX times in a row. Our team of award-winning nurses is growing, and we are looking for talented, compassionate RNs to join our team.The Utilization Review Nurse Per Diem will: Identify appropriate medical information necessary to certify and/or...

Clinical Reviewer Job DescriptionAs a Clinical Reviewer at IPRO, you will play a critical role in ensuring the accuracy and appropriateness of medical reviews. Your expertise will be utilized to conduct thorough clinical level reviews, supporting Medical Review Analysts and Physician Consultants in their decision-making processes.Key Responsibilities:Conduct...

Dane Street, a certified "Great Place to Work" company, is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized...

Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. As a key member of our healthcare recruitment team, you will play a crucial role in evaluating medication use patterns to promote safe and effective medication therapy, ensuring optimal patient outcomes.Key...

VNS Health is seeking a Utilization Review Registered Nurse (RN) for a nursing job in West New York, New Jersey. Responsibilities: Conduct clinical assessments including medication reconciliations and post-discharge transitions of care assessment Collaborate with programs to ensure compliance with regulatory requirements Lead and participate in quality...

Job Title: Utilization Management / Appeals RNMust have BSN***Location: Onsite required; offices in either Lake Success or Albany, NYHours: M-F 8-5Start date: ASAP, looking to get all RNs started togetherPay: $48-54/hr+ (negotiable)Experience: UM, Appeals, or strong clinical and analytical background to do claims adjudication.Volume: Will do appeals work...

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 OpportunityMomentum Resource Solutions is seeking a highly skilled Medical Director to join our team.Job SummaryThe Medical Director will play a crucial role in ensuring appropriate healthcare utilization management. As a physician and policy advisor, you will work closely with our Chief Medical Officer to develop and implement policies that promote...

Job SummaryWe are seeking a skilled RN Case Manager to join our team at Ochsner Health. This role will be responsible for performing pre-admission, admission, and continued stay reviews to ensure that patients receive the appropriate level of care.Key ResponsibilitiesConduct thorough reviews of patient hospitalizations to identify opportunities for...

Job SummaryWe are seeking a skilled RN Case Manager to join our team at Ochsner Health. As a key member of our utilization review team, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary hospital stays.ResponsibilitiesConduct thorough reviews of patient hospitalizations to identify...

Job SummaryOchsner Health System is seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will play a critical role in ensuring that patients receive the necessary care and resources to achieve optimal health outcomes.Key Responsibilities• Perform pre-admission, admission, and continued stay reviews to ensure that patients receive...

Job SummaryWe are seeking a skilled and compassionate Registered Nurse to join our team as a Case Manager. In this role, you will play a critical part in ensuring that patients receive the highest level of care and support throughout their hospital stay.Key ResponsibilitiesConduct thorough assessments of patients' medical needs and develop personalized care...