- Centene Corporation (Richmond, VA)
- …- 5pm Eastern with some holidays on a rotating basis.** + **Previous concurrent review experience is highly preferred.** **Position Purpose:** Performs ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a CDI Concurrent Review and Query Specialist? At HCA Healthcare, you come first. HCA Healthcare ... **Description** This is a fully remote role but you must live within 60...a difference. We are looking for a dedicated CDI Concurrent Review and Query Specialist like you… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates transitions of… more
- CVS Health (AZ)
- …+ Minimum of 1 year of experience in Oncology and Transplant either in UM, concurrent review , or prior authorization + 3+ years of experience in Acute clinical ... in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position… more
- Cognizant (Juneau, AK)
- …Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,...Based on this role's business requirements, this is a remote position open to qualified applicants in United States.… more
- CVS Health (AZ)
- …outpatient programs. + At least 1 year of Utilization Management experience in concurrent review or prior authorization. + Strong decision-making skills and ... members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at the forefront of… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services. The role involves… more
- HonorHealth (AZ)
- …Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Henry Ford Health System (Warren, MI)
- …and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous ... and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical experience required. +… more
- Vitalief (Philadelphia, PA)
- …and grow sustainably. The Role We are seeking an experienced Clinical Research Nurse to join our exceptional team as a full-time Vitalief employee. In this ... plans. + Hybrid schedule : 4 days on-site (Philadelphia), 1 day remote weekly. + Market-competitive salary , commensurate with experience. Responsibilities: + Under… more