- State of Colorado (Pueblo, CO)
- …or renewal of authorizations. + Reports current authorization information or concerns to the Utilization Review Manager , weekly, at a minimum. + Schedules ... CMS, and ORYX. This position provides back-up to the MRT III for utilization review . This position supports and provides back-up for all other duties listed… more
- University of Utah Health (Salt Lake City, UT)
- …the accurate reporting of time and attendance of direct reports. + Functions as Case Manager and/or Utilization Review Nurse as necessary. + Tracks and ... analyzes Case Manager quality of service and utilization statistics. + Works collaboratively with information systems personnel as needed to implement case… more
- CVS Health (Oklahoma City, OK)
- …delivery field as a psychiatrist. * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. * ... Health), you will: * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening + ... FTE:1 + Posted:July 14, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review ...in orientation of fresh staff as requested by the Manager of Utilization Management. 17. Maintains knowledge… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Baptist Memorial (Meridian, MS)
- Overview RN Utilization Review Weekender Job Code: 22818 FLSA Status Job Family: NURSING Job Description Title: RN Utilization Review Weekender Job ... necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance… more
- Beth Israel Lahey Health (Burlington, MA)
- …collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities ... Duties & Responsibilities** _including but not limited to:_ + Ensures that Utilization Review nurses are consistently recommending the appropriate admission… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral… more
- Trinity Health (Wilmington, DE)
- …Utilization Management** **Location:** Saint Francis Hospital **Department:** Care Management / Utilization Review **Schedule:** Per Diem | 1 Weekend per ... Coverage | 8hr shift **Position Purpose:** As a Case Manager in Utilization Management, you will be...in an acute care setting with a focus on Utilization Review . + **Education:** BSN preferred. +… more