- Centene Corporation (Sacramento, CA)
- …hold a current CA license.** **Must have** **2-4 years related** **experience in UM- Concurrent Review . 2+ years of acute care experience required. 10% Travel ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- Trinity Health (Troy, NY)
- …administrative requirements for Utilization Management and works collaboratively with Utilization Management/ Concurrent Review Nurse , physicians, staff and ... possible concurrent denials, forwards information to the appropriate Utilization Management/ Concurrent Review Nurse within identified process standards *… more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife-PD Days-MMG Concurrent -Jersey City-NJReq #:0000192616 Category: Nurse Midwife Status:Per Diem Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Pay Range:$94.76 per hour Location: 355 Grand Street,...355 Grand Street, Jersey CIty, NJ 07302 Job Title: Nurse Midwife Location: Jersey City Medical Center Department: MMG… more
- Actalent (Dallas, TX)
- Clinical Review Nurse (Utilization Management)100% Remote Job Description The role of the Utilization Management Nurse involves performing concurrent ... utilization management and utilization review expertise. + Experience in concurrent review and prior authorization. + Knowledge in managed care and patient… more
- Houston Methodist (Houston, TX)
- … functions through point of entry, observation progression of care management, concurrent review and denials reviews. Additionally, the URSN will prospectively ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is... (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- LifePoint Health (Louisburg, NC)
- Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound commitment to ... valid job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator* **Location:** *NC-Louisburg* **Requisition… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, insurance ... authorization per contracts for medically appropriate level of care. Manages concurrent clinical denials through completion of verbal reconsideration process. Works… more
- UNC Health Care (Kinston, NC)
- …assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of ... the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care,… more