Case Manager Utilization Review RN

Job Title: Utilization Review NurseWe are seeking a skilled Utilization Review Nurse to join our team at Children's Health. As a Utilization Review Nurse, you will play a critical role in ensuring that our patients receive the most appropriate and effective care possible.Responsibilities:Conduct thorough reviews of patient records to determine medical...

Job Title: Utilization Review RNChildren's Health is seeking a skilled Utilization Review Registered Nurse to join our team. As a Utilization Review RN, you will play a critical role in ensuring that our patients receive the highest quality care while minimizing unnecessary costs.Key Responsibilities:Conduct thorough reviews of patient records to determine...

Job SummaryAs a Clinical Utilization Review Specialist at the University of Texas Southwestern Medical Center, you will play a crucial role in ensuring the highest quality of care for our patients. Your primary responsibility will be to conduct medical certification reviews for medical necessity for acute care facilities and services.You will use nationally...

Job SummaryAs a Clinical Utilization Review Nurse at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the highest quality of care for our patients. Your primary responsibility will be to conduct medical certification reviews for medical necessity for acute care facilities and services. You will use nationally...

Job SummaryAs a Clinical Utilization Review Nurse at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the appropriate level of care for patients. You will conduct medical certification reviews for medical necessity, using nationally recognized guidelines to recommend the level of care to physicians. Your...

About the JobThis position is responsible for implementing and coordinating all utilization management functions relating to pre-certification of outpatient services. The LVN Case Manager in this capacity is responsible for coordinating authorizations and workflow, direction, organization, and monitoring of authorizations/utilization management. Coordinates...

Job SummaryAs a Utilization Review Registered Nurse at UT Southwestern Medical Center, you will play a critical role in ensuring the highest quality of care for our patients. Conduct medical certification reviews for medical necessity, utilizing nationally recognized guidelines to recommend the appropriate level of care. Collaborate with physicians and other...

Job OpportunityWe are seeking a skilled Physician Reviewer to join our team at Dane Street, LLC.About the Role:This telework opportunity provides the flexibility to customize your schedule and caseload within the week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Key...

Baylor Scott & White Medical Center – Uptown is a joint venture surgical hospital between Baylor Scott & White Health (BSWH), United Surgical Partners International (USPI), and local physicians.The hospital provides a wide range of medical and surgical services to the greater North Texas area.The Case Manager will be the leader in navigating the patient...

Job Title: Clinical Review NurseJob Summary:Elite PC Services is seeking a skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in reviewing Workers Compensation requests to determine medical necessity. Your expertise will be utilized to analyze medical data, apply evidence-based guidelines, and make...

Job Title: Neurologist Medical Review SpecialistConcentra is seeking a skilled Neurologist Medical Review Specialist to join our team. As a Medical Review Specialist, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.Responsibilities:Reviews...

About the Job:This position is responsible for implementing and coordinating all utilization management functions relating to pre-certification of outpatient services. The LVN Case Manager in this capacity is responsible for coordinating authorizations and workflow, direction, organization, and monitoring of authorizations/utilization management. Coordinates...

Case Manager IIAt Encompass Health, we're seeking a skilled Case Manager II to join our team. As a Case Manager II, you'll play a vital role in coordinating patient care from admission to post-discharge, ensuring seamless transitions and optimal outcomes.Key Responsibilities:Coordinate patient care with interdisciplinary teams to establish tentative...

Job SummaryAs a Medical Case Manager at Eberstein Witherite LLP, you will play a crucial role in ensuring the highest quality of care for our clients. Your primary responsibility will be to assist in the implementation of clinical models and systems throughout treatment modalities. This will involve advising on cases, assisting team members and clients...

About the RoleRightway Inc. is seeking a highly skilled Clinical Pharmacist to join our Pharmacy Benefit Management (PBM) team. As a key member of our Clinical Operations team, you will play a critical role in delivering our PBM strategy and actively working on utilization management cases.Key ResponsibilitiesSupport all lines of business by reviewing...

Job DescriptionWe're a fully licensed health insurer dedicated to making healthcare simple, transparent, and human. Our goal is to create a healthcare experience that's intuitive and puts people first.We're changing how health insurance works by using a consumer-focused and tech-driven approach. This positions us uniquely in the space and creates one of the...

Job Description:The Director of Hospital Operations is responsible for managing and coordinating department activities. This role ensures staff compliance with organizational policies and external regulatory agencies, taking leadership responsibility to coordinate the integration of the department's patient care and discharge planning processes with related...

About the RoleAt Rightway Inc, we are seeking a highly skilled Clinical Pharmacist to join our Utilization Management team. As a key member of our Clinical Operations team, you will play a critical role in delivering our Utilization Management strategy and actively working UM cases.Key ResponsibilitiesSupport all lines of business by reviewing utilization...

Job SummaryThe Director of Case Management Leadership at RightWorks Inc is responsible for overseeing the overall management and coordination of department activities. This includes ensuring staff compliance with organizational policies and external regulatory agencies, as well as taking leadership responsibility to coordinate the integration of the...

Case Manager PRN Job DescriptionBaylor Scott & White Medical Center – Uptown is a joint venture surgical hospital between Baylor Scott & White Health (BSWH), United Surgical Partners International (USPI), and local physicians.The hospital specializes in both inpatient and outpatient procedures in Orthopedics, Joint Replacement, Spine, General, Bariatrics,...