Utilization Review Nurse

Utilization Review Nurse for Workers' Comp Job Purpose: Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines. Duties: Perform an evaluation of the medical data for utilization review...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. pay rate is $40/hour This position is responsible for performing initial, concurrent review...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. pay rate is $40/hour This position is responsible for performing initial, concurrent review...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. pay rate is $40/hour This position is responsible for performing initial, concurrent review...

Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with...

Utilization Review RN with Acute Care Experience - PRN - Monday-Friday Days Epic/MCG Experience Required Three (3) years of utilization review experience in hospital/acute care setting required JOB SUMMARY Conduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines...

Utilization Review RN with Acute Care Experience - PRN - Monday-Friday Days Epic/MCG Experience Required Three (3) years of utilization review experience in hospital/acute care setting required JOB SUMMARY Conduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines...

Position Title Department Utilization Management Coordinator Business Office Direct Manager of Position Exempt Status Director, Business Services False False False Center False Exempt X False False False Center False 1 Nonexempt Job Summary The Utilization Management Coordinator supports Insurance Verification (IV) by securing pre-certification for...

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a...

Registered Nurse (RN) For this position, we are seeking a Registered Nurse (RN) who must hold a compact license. This is a remote position, home office with high-speed internet connectivity required. Work Schedule: Monday to Friday, operation hours 6 AM to 6 PM (Team will work on set schedule). Looking for an RN with experience with appeals, claims review,...