Utilization Review Nurse

Job Title: Utilization Review RNJob Summary:The Utilization Review RN 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 and healthcare teams.Key Responsibilities:Conduct thorough reviews of...

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 communicating with payors regarding clinical updates.Key Responsibilities Reviews patient medical records to collect data 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 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 Title: Utilization Management Review NurseAbout the Role:Astrana Health is seeking an experienced Utilization Review Nurse to work remotely from Texas. This position requires a strong understanding of state and federal regulations and accreditation standards. The ideal candidate will have excellent interpersonal skills and the ability to collaborate with...

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 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 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 SummaryWe are seeking a highly skilled Document Reviewer to join our team at TRC Companies, Inc. The successful candidate will be responsible for reviewing and managing documents related to our Right of Way (ROW) activities.This is a unique opportunity to work with a leading company in the industry, utilizing your expertise to ensure the accuracy and...

Job SummaryWe are seeking a highly skilled RN Clinical Reviewer to join our Quality Management team at HCA Houston Healthcare Northwest. As a key member of our team, you will play a vital role in ensuring the highest quality of care for our patients.ResponsibilitiesPromote a culture of excellence and patient safety within our hospital.Facilitate the growth...

Job SummaryWe are seeking a highly skilled RN Clinical Reviewer to join our Quality Management team at HCA Houston Healthcare Northwest. As a key member of our team, you will play a vital role in ensuring the delivery of high-quality, patient-centered care.ResponsibilitiesPromote a culture of excellence and quality within our hospital, fostering a positive...

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 SummaryWe are seeking a highly skilled RN Clinical Reviewer to join our Quality Management team at HCA Houston Healthcare Northwest. As a key member of our team, you will play a vital role in ensuring the highest quality of patient care and promoting a culture of safety and excellence.ResponsibilitiesPromote a positive culture that values individual...

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...

At UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone.The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.As a Telephonic Oncology Preservice Review Nurse, you...

Job SummaryWe are seeking a highly skilled Utility Technician to join our team at The City of Houston. As a Utility Technician, you will be responsible for the maintenance and operation of our water and wastewater utility systems.Key ResponsibilitiesPerform routine maintenance and repairs on water and wastewater treatment plants and equipment.Operate and...

Job SummaryBGE, Inc. is a leading consulting firm providing services in civil engineering, planning, landscape architecture, construction management, survey, and environmental services. We offer a comprehensive benefits package, including outstanding healthcare, generous 401(k) match, career mapping, and flexible work arrangements.Key...