RN Utilization Review

Job DescriptionJob DescriptionJob descriptionWe have 2 job openings available for RN Nurse Case Manager.Overview: 1*Will oversee Case Managers at the Hospital and Pediatric Center.*Strong knowledge of utilization review processes, authorizations, denials/appeals and discharge planning. Experience as a manager of a team of employees.*7 yrs clinical nursing...

General Summary of PositionAre you an experienced Utilization Review Nurse looking for a PRN position to include some weekends? MedStar Health Washington Hospital Center is seeking a PRN UR Nurse to fill in as needed to include some weekends.Position OverviewUnder the direction of The Director of UM/Appeals assists in the administration of utilization...

General Summary of PositionUnder the direction of The Director of UM/Appeals assists in the administration of utilization functions, the Utilization Review Nurse, assesses patient insurance/status to facilitate appropriate completion of utilization review using payer specific criteria; uses Interqual and MCG to determine medical necessity and appropriateness...

Job Summary:MedStar Medical Group is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate and cost-effective care.Key Responsibilities:Conduct thorough admission, concurrent, and retrospective case reviews to identify opportunities for...

Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our...

Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our...

Description Remote - Utilization Review RN On call/Per diem The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient...

Description Remote - Utilization Review RN On call/Per diem The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient...

Description The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate admission...

Description The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate admission...

General Summary of PositionConducts admission, concurrent, and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way. Primary Duties and...

Job SummaryWe are seeking a highly skilled Clinical Review Coordinator to join our team at Universal Health Services (UHS). As a Clinical Review Coordinator, you will play a critical role in facilitating clinical pertinence reviews on patient admissions and continued stays, ensuring that our patients receive the highest level of care.Key...

Are you a skilled Utilization Review Nurse seeking a flexible PRN role that includes weekend shifts? MedStar Health Washington Hospital Center is looking for a PRN UR Nurse to provide support as needed, including weekends.Position Summary Under the supervision of the Director of Utilization Management and Appeals, the Utilization Review Nurse plays a crucial...

Are you a skilled Utilization Review Nurse seeking a flexible PRN role that includes weekend shifts? MedStar Health Washington Hospital Center is currently looking for a PRN UR Nurse to provide coverage as needed, including weekends.Position Summary Under the supervision of the Director of Utilization Management/Appeals, the Utilization Review Nurse plays a...

Job Summary:Medical Solutions is seeking a skilled Registered Nurse to fill a Case Management position in Richmond, VA. As a travel nurse, you will have the opportunity to work in a dynamic and fast-paced environment, utilizing your expertise to make a positive impact on patient care.Responsibilities:Provide high-quality patient care in a Case Management...

Overview of the RoleUnder the supervision of the Director of Utilization Management and Appeals, the Clinical Review Nurse plays a pivotal role in managing utilization processes. This position involves evaluating patient insurance status to ensure the effective execution of utilization reviews in accordance with payer-specific guidelines. The nurse utilizes...

Overview of the RoleUnder the supervision of the Director of Utilization Management and Appeals, the Clinical Review Nurse plays a crucial role in the management of utilization processes. This position involves evaluating patient insurance and status to ensure the effective execution of utilization reviews based on payer-specific guidelines. The nurse...

Job DescriptionJob DescriptionDescriptionThe Clinical Review Specialist is responsible for proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims. Responsibilities include drafting appeal letters based on clinical judgment and knowledge. This is a remote position with the...

Job DescriptionJob DescriptionDescriptionThe Clinical Review Specialist is responsible for proper clinical review and interpretation of medical records and claim documentation to assist with the appeals of denied insurance claims. Responsibilities include drafting appeal letters based on clinical judgment and knowledge. This is a remote position with the...

Major purpose of this job: The Accreditation Reviewer is an expert in the content and interpretation of accreditation programs and standards. Primary responsibilities include analyzing accreditation application documentation and conducting validation reviews. Key additional responsibilities include participating in the standards development/revision process,...