Utilization Management Review Nurse Specialist

Job Summary:The Utilization Review Specialist is a key member of our healthcare team, responsible for ensuring the medical necessity of patient admissions and continued stays. This role requires a strong clinical background, excellent communication skills, and the ability to work collaboratively with physicians and other healthcare professionals.Key...

h3Job Description/h3pAt Nexus Health Systems Ltd, we are seeking a skilled bClinical Utilization Review Specialist/b to join our team. As a key member of our healthcare team, you will play a vital role in ensuring the delivery of cost-effective quality care within an appropriate length of stay./ppbKey Responsibilities:/b/pulliMaintain patient confidentiality...

Job SummaryThe Utilization Review Nurse is responsible for ensuring the medical necessity of patient admissions and continued stays. This role involves reviewing patient medical records, evaluating the appropriateness of care, and communicating with payors regarding clinical updates.Key Responsibilities Reviews patient medical records to collect data and...

Job Summary:As a Utilization Review Nurse at Care, you will play a vital role in ensuring the highest quality patient care while promoting efficient resource utilization. Your expertise will be instrumental in facilitating critical criteria reviews, collaborating with managed care organizations, and maintaining accurate records. If you are a dedicated and...

Job SummaryThe Utilization Review Nurse is responsible for ensuring the medical necessity of patient admissions and continued stays. This role involves reviewing patient medical records, evaluating the appropriateness of care, and collaborating with healthcare teams to optimize resource utilization.Key Responsibilities* Review patient medical records to...

Job Title: Utilization Review RNJob Summary:We are seeking a skilled Utilization Review RN to join our team at St. Joseph Medical Center. As a Utilization Review RN, you will play a critical role in ensuring that patients receive the necessary care and services to achieve optimal health outcomes.Key Responsibilities:Conduct thorough reviews of patient...

Job Title: Utilization Management Review NurseAbout the Role:Astrana Health is seeking an experienced Utilization Review Nurse to work remotely from Texas. This position requires working Monday through Friday from 8:30 a.m. to 5 p.m., with occasional weekend and holiday coverage as needed.Key Responsibilities:1. Conduct prior authorization and retrospective...

Job TitleNurse Utilization SpecialistJob Summary:Elite is seeking a skilled Nurse Utilization Specialist to join our team. As a key member of our clinical review team, you will play a critical role in ensuring the medical necessity of treatment requests submitted by providers, requestors, claimants, or carriers.Responsibilities:Conduct thorough evaluations...

Job SummaryUPS Industrial Services is seeking a skilled Contract Review Specialist to join their team. The successful candidate will be responsible for drafting, reviewing, and negotiating contracts and agreements for clients and subcontractors in various industries.Key Responsibilities:Coordinate the review of contract documents to identify potential risks...

Job Title: Clinical Review NurseJob Summary:HealthHelp, a WNS Global Services company, is seeking a skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in ensuring the quality and safety of patient care by reviewing medical necessity criteria and facilitating resolution of escalated cases.Key...

Job SummaryHealthHelp, a leading provider of healthcare utilization and care management services, is seeking a skilled Clinical Review Nurse to join our team. As a key member of our clinical review team, you will play a critical role in ensuring the quality and safety of patient care.Key ResponsibilitiesPerform thorough clinical reviews of cases to determine...

Job SummaryWe are seeking a skilled Utilization Management Clinical RN to join our team. In this role, you will be responsible for providing precertification of inpatient hospitalizations and outpatient procedures, as well as conducting telephonic and concurrent reviews of inpatient hospitalizations and extended courses of outpatient treatment.Key...

Job OverviewCypress Creek Personnel is seeking a skilled Credit Review Specialist to join our team. In this role, you will assist in preparing credit reviews and recommendations for approval, ensuring that our customers receive the best possible credit terms.Assist in Credit Review ProcessContact prospective client references to assess their suitability for...

Job Summary:Amergis is seeking a skilled Utilization Management Clinical RN to join our team. As a key member of our team, you will be responsible for analyzing submitted information, creating case summaries, and collaborating with medical directors to ensure accurate and timely decision-making.Responsibilities:Analyze clinical assessments, treatment plans,...

Job Title: Image Review Audit Validation SpecialistThe Image Review Audit Validation Specialist plays a crucial role in ensuring the accuracy and quality of the image review process. This position is responsible for verifying the accuracy of reviewed images from the Image Review and Image Review Audit teams.Key Responsibilities:Reviews images to ensure...

Job DescriptionThe Image Review Audit Specialist is responsible for ensuring the accuracy of the image review process by validating reviewed images from the Image Review and Image Review Audit teams. This position will verify an established number of images daily for accuracy and quality of work and will prepare and submit the audit data for management...

Morae Global is seeking a skilled Document Review Specialist to join our team in Houston, Texas. As a key member of our document review project, you will be responsible for conducting detailed reviews of documents for relevance, privilege, and confidentiality.Key Responsibilities:Conduct thorough reviews of documents to ensure accuracy and quality.Accurately...

Job Title: Image Review Audit Validation SpecialistThe Image Review Audit Validation Specialist plays a crucial role in ensuring the accuracy of the image review process. This position is responsible for validating reviewed images from the Image Review and Image Review Audit teams to ensure that they meet the required standards.Key Responsibilities:Reviews...

Job Summary:We are seeking a highly skilled Utility Coordination Specialist to join our team at The Bergaila Companies. As a key member of our engineering team, you will be responsible for ensuring the safe operation of our pipeline facilities through engineering evaluation and communication with stakeholders.Key Responsibilities:Review and evaluate project...

Job Title: Financial Examiner V: Credit Review SpecialistThis is a challenging and rewarding role that requires a strong understanding of credit risk measurement and risk management practices. As a Financial Examiner V: Credit Review Specialist, you will be responsible for conducting credit reviews during onsite examinations, analyzing internal reports, and...