Utilization Review RN

We are seeking a skilled Clinical Utilization Review Specialist to join our team at LifeBridge Health. In this part-time, weekend position, you will conduct concurrent and retrospective chart reviews to ensure clinical, financial, and resource utilization information is accurate and efficient.Job SummaryThis role requires strong critical thinking skills, the...

Part-time Utilization Review / Case Management RNWe are seeking a highly skilled Registered Nurse to join our team in a part-time utilization review and case management role. This position is ideal for an individual who enjoys analyzing medical data, identifying opportunities for improvement, and collaborating with healthcare professionals to optimize...

Key ResponsibilitiesThis role is an exciting opportunity for a skilled nursing professional to contribute to the delivery of high-quality patient care at LifeBridge Health.Salary Range:$38.20-$59.21 per hour, based on experience.Job DescriptionAs a Clinical Utilization Review Specialist, you will play a vital role in ensuring that patients receive necessary...

Job SummaryThe Lead Utilization Review Nurse Consultant plays a pivotal role in guiding the utilization review staff in concurrent and retrospective review, care management, denials, and appeals programs. This clinical resource lends expertise to ensure the effective implementation, maintenance, and evaluation of an integrated care management program. The...

Job SummaryThe Lead UR Nurse serves as a clinical resource and lends guidance to Utilization Review staff in concurrent and retrospective review, utilization care management and denials and appeals programs.Key Responsibilities:Clinical Resource: Provide oversight, training, guidance, and assistance to staff regarding concurrent review, retrospective review,...

LifeBridge Health is seeking an experienced RN Utilization Review Specialist to join our team on a part-time basis. This position will be based at Grace Medical Center in Baltimore, MD.Job SummaryThe RN Utilization Review Specialist will conduct concurrent and retrospective chart reviews for clinical, financial, and resource utilization information. The...

About the RoleWe are seeking a highly skilled Lead Utilization Review Nurse to join our team at LifeBridge Health. In this critical role, you will serve as a clinical resource and lend guidance to Utilization Review staff in concurrent and retrospective review, utilization care management, and denials and appeals programs.Responsibilities

What You'll DoThis RN Medical Necessity Review Lead will be responsible for leading teams of registered nurses who conduct reviews of patient treatments to determine their medical necessity. The successful candidate will have excellent communication skills, the ability to analyze complex data, and the ability to make decisions that align with company...

About the Position:This RN Utilization Review position is an excellent opportunity for a motivated and detail-oriented individual to join our team at Ascension Saint Agnes. As a member of our team, you will have the chance to make a meaningful impact on the lives of patients and families by ensuring that they receive high-quality, patient-centered care.Key...

At LifeBridge Health, we are committed to providing exceptional patient care and advancing the field of healthcare. We are seeking a skilled Utilization Review Nurse to join our team.About the RoleThis is a full-time position with weekend coverage, requiring a minimum of four 10-hour shifts per week. The ideal candidate will have strong clinical expertise...

About the RoleThis Clinical Utilization Manager position is responsible for managing effective utilization review processes, including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites. A key focus of this role is to develop and implement quality review programs and key performance indicators...

About the Role:We are seeking an experienced RN Utilization Review Professional to join our team at Ascension Saint Agnes. This position involves reviewing admissions and service requests for medical necessity and compliance with reimbursement policy criteria. The ideal candidate will possess strong analytical and communication skills, as well as a deep...

About the JobWe're seeking an experienced Utilization Management Specialist to join our team. This role involves reviewing medical records, making decisions on patient care, and collaborating with healthcare professionals to ensure the best possible outcomes.The salary for this position is estimated to be around $85,000 per year, based on national averages...

We are seeking a skilled Clinical Utilization Specialist to join our team at LifeBridge Health. This is a full-time position with a weekend commitment, requiring four 10-hour shifts per week.Job Summary: The Clinical Utilization Specialist will conduct concurrent and retrospective chart reviews to assess clinical, financial, and resource utilization...

About the RoleMedical Record ReviewerWe are looking for a Medical Record Reviewer to join our Quality Team at Collabera. As a HEDIS Nurse, you will be responsible for reviewing medical records, ensuring accuracy and completeness.Key Responsibilities:Retrieve and document medical records.Conduct medical record abstraction using HEDIS...

At Latitude Inc, we are seeking a highly skilled Medical Claims Review Specialist to support our Federal Team in ensuring the accuracy and compliance of medical claims. This role involves reviewing complex medical records, billing, and claims cases/projects, evaluating coding practices, and applying clinical guidelines and coverage criteria during...

At LifeBridge Health, we are seeking a skilled Clinical Review Nurse Specialist to join our team. This full-time position offers an exciting opportunity to work in a dynamic environment where you can make a meaningful impact on patient care.The successful candidate will be responsible for conducting concurrent and retrospective chart reviews to assess...

About the RoleCareFirst BlueCross BlueShield is seeking a seasoned Clinical Quality Assurance Specialist to join our team in the Government Programs Appeals Department. As a key member of our quality review team, you will be responsible for evaluating clinical quality and procedures within our department, ensuring compliance with regulatory standards.The...

Job Title: Utility Outage Operations ManagerThe University of Maryland Medical System seeks a highly skilled and experienced Utility Outage Operations Manager to join our team.Overview:As a key member of our facilities management team, the successful candidate will be responsible for overseeing the utility outage program, ensuring minimal disruption to...

Overview\The University of Maryland Medical System is a leading academic medical center with a reputation for excellence in patient care, research, and education. As a key member of our team, you will play a critical role in ensuring the smooth operation of utilities within our system.\About the Job\We are seeking an experienced Utility Outage Program...