- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team....provided to patients are appropriate and covered by the insurance payer. They are responsible for ensuring that patient… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the ... Patient Accounting Centers (CPAC) for revenue reimbursement. The RUR nurse applies advanced clinical knowledge, communication skills, and collaboration to… more
- CDPHP (Latham, 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 ... and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people,… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... review of relevant medical documentation, medical guidelines, and insurance benefits and communicates information to payers in accordance with contractual… more
- Penn State Health (Reading, PA)
- …status, and family medical or genetic information._ **Position** RN Registered Nurse Patient Safety/Peer Review /Mortality - Quality Services **Location** ... to improve reliability of systems. Accountable for medical staff peer review coordination to support medical staff clinical quality professional practice evaluation.… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 PM ... and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a diligent and detail-oriented Post Review Nurse to perform timely ... claims assessments using InterQual criteria and medical policy. + Review medical records for suspended claims and provider inquiries...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Children's Mercy Kansas City (Kansas City, MO)
- …lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, ... status and continued patient stays with Attending Physician, Physician Advisor, Inpatient Nurse Care Manager, and insurance /payer. + Collaborates with Revenue… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , P26749 ... Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily Utilization … more
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