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 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 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 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...

We are seeking a skilled Registered Nurse to join our team as a Utilization Review Specialist. This role requires expertise in clinical reviews and experience with Interqual or Milliman.About the JobAs a Utilization Review Specialist, you will be responsible for reviewing patient cases to determine the level of care required. You will work closely with...

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 Overview: Fastaff Travel Nursing is seeking a highly skilled medical professional to fill a utilization review position in New York.Estimated Salary: $140,000 per year, based on industry standards and location factors.About the Job: As a travel nurse RN, you will be responsible for conducting thorough utilization reviews to ensure patients receive the...

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...

About CarolinaEast Medical CenterCarolinaEast Health System is a leading healthcare provider in the Coastal Carolina region, committed to delivering high-quality, compassionate care to our patients. We are dedicated to creating a culture of excellence that connects our patients to the same level of care found at larger medical centers while maintaining a...

Job Title: Utilization Management / Appeals RN Must have BSN*** Location: Onsite required; offices in Lake Success/New Hyde Park, NY Hours: M-F 8-5 *flexible Start date: ASAP Pay: $48-54/hr *DOE Experience: UM, Appeals, or strong clinical and analytical background to do claims adjudication. Volume: Will do appeals work under the IDR team handling on...

Job OverviewMJHS is a leading healthcare organization dedicated to providing high-quality care and services to our patients and members. As a Healthcare Utilization Review Specialist, you will play a critical role in ensuring that our health plan members receive the necessary services and support to maintain their independence and quality of life.

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...

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...

About Dane StreetDane Street is an independent review organization and a national provider of utilization review services. We offer a unique opportunity for physicians to expand their panel, resulting in non-traditional work and supplemental income.

Position Summary: This role involves reviewing service requests from providers, determining medical necessity based on evidence-based criteria, providing authorization for services, and managing day-to-day operations. The Clinical Review Nurse acts as a liaison between participants and providers, ensuring compliance with regulatory and contractual...

Clinical Review Nurse Role OverviewAt Medix, we are seeking a skilled Clinical Review Nurse to join our team. The successful candidate will act as a liaison between participants and providers, ensuring compliance with regulatory and contractual requirements.Key ResponsibilitiesReview and process service authorization requests from providers in a timely and...

At the New York State Office of Mental Health, we are seeking a skilled Healthcare Utilization Specialist to join our team.Job OverviewThe selected candidate will work with us to analyze and evaluate quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness. This role is responsible for...

Current Saint Francis Employees - Please click HERE to login and apply.This position is ECB status - requires a minimum number of worked hours per month as needed by the department; limited benefit offerings.#ALDINDShift: EveningsJob Summary: Provides administrative and clinical support to the hospital and treatment teams throughout the review of patients...

Job OverviewMEDNATIONAL is seeking an experienced Utilization Management (UM) Nurse to join our team. This role involves assessing healthcare services to ensure optimal patient outcomes and compliance with regulatory standards.Key Responsibilities:Service Assessment and Compliance: Evaluate healthcare services to guarantee optimal patient outcomes and...