Utilization Review Nurse

About MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay area, offering a comprehensive range of services to meet the diverse needs of our community. We are seeking a highly skilled Utilization Review Nurse to join our team of dedicated healthcare professionals.Job Summary:The Utilization Review Nurse will...

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the UM program by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and...

Job DescriptionMedRisk is seeking a skilled Clinical Reviewer to join our team in the utilization review program. As a Clinical Reviewer, you will play a critical role in promoting quality outcomes and enhancing the physical, psychosocial, and vocational health of individuals.Key Responsibilities:Evaluate medical data for utilization review requests and...

About MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay, offering a unique blend of academic medicine and personalized care. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the right care at the right time.Job SummaryThe Utilization Review Nurse is responsible...

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the UM program by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and...

Job SummaryThe Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the UM program by developing and/or maintaining effective and efficient processes for determining the appropriate admission status based on the regulatory and...

Description: As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination is to assist in managing care, cost, and outcomes across the continuum of patient care as it relates to acute inpatient stay and post-acute facility stay. The Utilization Review RN Coordinates...

Description: As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination is to assist in managing care, cost, and outcomes across the continuum of patient care as it relates to acute inpatient stay and post-acute facility stay. The Utilization Review RN Coordinates...

Description: As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination is to assist in managing care, cost, and outcomes across the continuum of patient care as it relates to acute inpatient stay and post-acute facility stay. The Utilization Review RN Coordinates continuing...

Job Title: Healthcare Utilization Review SpecialistCare Review Clinician, Prior Authorization (Registered Nurse, or LVN)Key Responsibilities:Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.Refers appropriate prior authorization requests to Medical Directors.Collaborates with multidisciplinary...

FLSA Status: Non-Exempt Department: Health Services Reports To: Health Services Management Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521 GENERAL DESCRIPTION OF POSITION Under the guidance and direction of the UM department RN Manager or Director, the Utilization Management...

Job Title: Travel Registered Nurse Utilization Review SpecialistJob Summary:Healthcare Staffing Plus is seeking a skilled Travel Registered Nurse Utilization Review Specialist to join our team. As a Utilization Review Registered Nurse, you will be responsible for assisting in developing and maintaining policies and procedures for the Service Area or Medical...

Job SummaryThe Utilization Review (UR) Nurse plays a critical role in ensuring the efficient and effective management of patient care. This individual is responsible for developing and maintaining processes that ensure compliance with regulatory and reimbursement requirements. The UR Nurse performs concurrent and retrospective reviews, ensuring that data is...

Compensation : $60 - $60 Hourly Client Job Ref ID : 138329 Shift Description : 06/01/2023 Travel Registered Nurse - Utilization Review San Diego, California, United States - 91911 Job Title: Travel Nurse - Utilization Review Shift: Evening or night shifts - 36 hours (weekends rotating) Duration: 13 weeks Start Date: 06/01/2023 Hourly Pay: $60 OT: 1.5...

Job SummaryThe Utilization Management Review Nurse LVN is responsible for conducting clinical reviews to ensure effective and appropriate utilization of benefits and services for prospective, concurrent, and retrospective/claims review organization determination authorization requests within regulatory turnaround requirements for all SCFHP lines of...

Job Title: Travel Registered Nurse - Utilization Review SpecialistJob Summary:We are seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team at Healthcare Staffing Plus. As a Utilization Review Specialist, you will play a critical role in developing and maintaining policies and procedures for the Service Area or Medical...

Compensation : $60 - $60 Hourly Client Job Ref ID : 138758 Shift Description : Day shifts - 36 hours (weekends rotating) Travel Registered Nurse Utilization Review San Diego, California, United States - 91911 Job Title: Travel Nurse - Utilization Review Number of positions: 1 Shift: Day shifts- 36 hours (weekends rotating) Duration: 13 weeks Start...

Job Description:RN Case Manager Job Requirements:As a RN Case Manager with HexaQuEST Health, Inc., you will be responsible for conducting patient initial assessments, utilizing your strong Utilization Review experience to ensure the best possible outcomes. You will work in an acute Care hospital setting, utilizing your EPIC EMR documentation skills to...

Job SummaryThe Utilization Management Nurse is a key member of our interdisciplinary team, responsible for evaluating the efficiency and appropriateness of treatments and services provided to patients. This role requires strong clinical expertise, excellent communication skills, and the ability to work collaboratively with healthcare professionals to ensure...

Job Description Overview: Medata is seeking Initial Clinical Reviewers to work in our utilization review program. UR is a collaborative process to promote quality outcomes, which enhance the physical, psychosocial, and vocational health of individuals. The Initial Clinical Reviewer applies and provides technical knowledge and experience to the field of...