- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... continued stay review. + Communication to third-party payers for initial and concurrent clinical review. + Reviews patient chart to ensure patient continues to meet… more
- State of Colorado (Golden, CO)
- Lead Mid-Level Provider / Nurse Practitioner - Campus at Lookout Mountain Youth Services Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185040) Apply Lead Mid-Level Provider / Nurse Practitioner - Campus at Lookout Mountain Youth Services… more
- Nuvance Health (Danbury, CT)
- …or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience in an acute care setting * ... and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case… more
- Catholic Health (Buffalo, NY)
- …is vital. Responsibilities: EDUCATION + Bachelor of Science Nursing (BSN) degree + Registered Nurse with a current New York State license CERTIFICATION + ... mentoring Utilization Review, Clinical Documentation Integrity and Clinical Denials and Appeals teams. They ensure...payers strongly preferred + Must maintain New York State RN license EXPERIENCE + Minimum of eight (8) years… more
- US Tech Solutions (Columbia, SC)
- …the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... team works with multiple applications to process authorization and appeals requests using Medicare criteria. **Responsibilities:** + Reviews and evaluates… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating...conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care ... remote environment. This role is ideal for nurses who enjoy clinical evaluation, structured decision‑making, and collaborating with providers to ensure appropriate… more
- System One (Baltimore, MD)
- Job Title: Clinical Medical Review Nurse Location: Baltimore, MD 21224 Type: Contract, 5 mos with chance of extension Compensation: Based on experience starting ... per week, plus occassional travel to providers for record retrieval, as needed. Clinical Medical Review Nurse / Medical Records Abstraction Specialist Schedule:… more
- Huron Consulting Group (Chicago, IL)
- …Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new ... partnerships, clinical services and technology is not enough to create...Improvement: Provides analysis and reports of utilization, denials, and appeals KPIs, trends, patterns, and impacts to resources. Tracks,… more
- State of Colorado (Denver, CO)
- …their job duties. This position works under the supervision and direction of a registered nurse and assists with psychiatric nursing care of mentally ill ... include: Provide Therapeutic Patient Care: Under the direction and supervision of a registered nurse , engage with patients to establish and maintain a… more