- AdventHealth (Hinsdale, IL)
- …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial ... and updates, as needed. Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all assigned patients… more
- AdventHealth (Bolingbrook, IL)
- …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial ... needed. . Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all...for services out of pocket. . Ensures primary care physician identification and scheduling of follow-up PCP and specialist… more
- University of Rochester (Rochester, NY)
- …time and effort of providers. Finds missing orders and sends them for review and approval. Anticipates needs of insurance companies by gathering all necessary ... based on provider's patient notes. Composes, edits and obtains signatures for non -routine letters of correspondence related to appeals on denied claims, including… more
- The County of Los Angeles (Los Angeles, CA)
- …squatting. Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission or continued...Nurse? In the County of Los Angeles, a Utilization Review Nurse is an RN that has Case… more
- Novant Health (Rocky Point, NC)
- …to assure effective care is given to provide quality patient care in physician practices. Supervises up to 9 FTEs. "America's Best-In-State Employers 2025 (six years ... package. https://www.novanthealth.org/team-members/benefits/ + Career advancement opportunities + Clinical and non -clinical positions available + Tuition reimbursement + We are… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …physician and/or physician advisor. This individual will: + Perform utilization review by completing a timely and comprehensive review of all new ... + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible for conducting medical necessity reviews… more
- Houston Methodist (Houston, TX)
- … Advisor to address identified educational needs for providers and utilization review / case management team members. + Serves as the primary information ... At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed...and data in a comprehensive manner. + Works with physician leadership and the interprofessional health care team for… more
- Sharp HealthCare (San Diego, CA)
- …in risk management reviews. + Assists in pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit review ... with the Quality Improvement Director. + Assists in POS/PPO Case Management and high-cost review with CMO...the process for identifying Potential Quality Issues. + Supervises Physician Reviewer (s) and Medical Directors including Behavioral… more
- Beth Israel Lahey Health (Boston, MA)
- …difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining the ... **Work Shift:** Day (United States of America) **FLSA Status:** Non -Exempt **When you join the growing BILH team, you're...Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records… more
- Cleveland Clinic (Cleveland, OH)
- ** Non -Invasive and Invasive Cardiologists** Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute Cleveland Clinic Regional Cardiovascular Medicine ... Non -Invasive, Invasive Cardiologist _Cleveland Clinic is recognized in the...at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. This dynamic position commands an… more