Utilization Review Nurse

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Trinity Health. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary costs.Key ResponsibilitiesReview hospital admissions to determine medical necessity and ensure...

Overview: The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission. Responsibilities: Job Summary Utilization Review, Utilization Management, Advocacy and Education Clinical Analysis and Data Management Clinical Care...

Overview: The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission. Responsibilities: Job SummaryUtilization Review, Utilization Management, Advocacy and EducationClinical Analysis and Data ManagementClinical Care...

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. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...

Job Title: Utilization Review Clinician - ABAJoin Centene Corporation, a leading healthcare company, as a Utilization Review Clinician - ABA. In this role, you will play a critical part in ensuring the medical appropriateness of Applied Behavioral Analysis (ABA) services for our members.Key Responsibilities:Evaluate member care and health status before,...

Employment Type:Part timeShift:Description:Utilization Review RN, Case ManagementWhy Mount Carmel?              With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in...

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. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF FLORIDA***Position...

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...

Job DescriptionNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).Work ShiftDayWork Day(s)Monday-Friday, VariableShift Start Time8:00 AMShift End Time4:00 PMWorker Sub-TypePRNChildren’s is one of the nation’s leading children’s...

Job DescriptionNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).Work ShiftDayWork Day(s)Monday-Friday, VariableShift Start Time8:00 AMShift End Time4:00 PMWorker Sub-TypePRNChildren’s is one of the nation’s leading children’s...

Details Department: Case Management Schedule: Full-Time, Monday-Friday (8:00A - 4:30P) Hospital: Ascension St Thomas Location: Nashville, TN - - - ****TN Nursing License is REQUIREDBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee...

OverviewThe Utilization Review RN serves as a leader resource in the Utilization Review process. They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. The UR RN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are...

Overview The Utilization Review RN serves as a leader resource in the Utilization Review process. They collaborate with physicians and other members of the healthcare team to promote and adhere to regulatory compliance. The UR RN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are...

Details Department: Utilization Review Schedule: Full time days; 8:00AM-4:30PM Monday-Friday Hospital: Ascension Sacred Heart Pensacola Location: Pensacola, Florida Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance...

Details Department: Case ManagementSchedule: Full-Time, Monday-Friday (8:00A - 4:30P)Hospital: Ascension St ThomasLocation: Nashville, TN ****TN Nursing License is REQUIREDBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance...

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team at MedStar Health. As a key member of our case management team, you will play a critical role in ensuring high-quality patient care while promoting efficient use of hospital resources.Key ResponsibilitiesConduct thorough admission, concurrent, and retrospective case reviews to...

Job DescriptionNote: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here. Submit your application via Workday using the Career App (Find Jobs).Work ShiftVariableWork Day(s)VariableShift Start Time8:00 AMShift End Time4:00 PMWorker Sub-TypePRNChildren’s is one of the nation’s leading children’s hospitals....

Job Title: RN Utilization Review SpecialistSouth Central Health System is seeking a highly skilled RN Utilization Review Specialist to join our team. As a key member of our Medical Staff Office, you will play a critical role in ensuring the quality and safety of patient care.Responsibilities:Collect and prepare data from medical records for OPPE and FPPE...

Job DescriptionWork ShiftCapital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical...

Description Provide prospective, retrospective and concurrent utilization review for St. Mary Medical Center. Provide clinical reviews and medical records daily during admission for all payers as required by the health plans. Requires a strong clinical background blended with a well-developed knowledge and skills in Utilization Management,...