• Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION II: ... UTILIZATION REVIEW NURSE SUPERVISOR...for medical care evaluation studies. + Attends Utilization Review Committee meetings to inform the… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… more
    The County of Los Angeles (06/28/25)
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  • Utilization Review Nurse

    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 medical record review for medical ...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (07/25/25)
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  • Utilization Review Nurse (40…

    State of Connecticut, Department of Administrative Services (New Haven, CT)
    Utilization Review Nurse (40...third-party administrator files to oversee contractor handling; + May review medical records of various health care ... is seeking a highly motivated and compassionate U tilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612FP&R1=&R3=) to join our team!… more
    State of Connecticut, Department of Administrative Services (07/23/25)
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  • Utilization Review Registered…

    Emory Healthcare/Emory University (Atlanta, GA)
    …_development,_ and leadership programs + And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting ... and when necessary, discussions with the provider team and/or Medical Director of UR. + Primary duties and responsibilities:...experience or a minimum of two years of previous utilization review experience. + Licensure - Must… more
    Emory Healthcare/Emory University (08/08/25)
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  • Utilization Management Review

    AmeriHealth Caritas (LA)
    …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday,… more
    AmeriHealth Caritas (06/25/25)
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  • Utilization Management Review

    AmeriHealth Caritas (Washington, DC)
    …Systems to efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care ... Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Current driver's license required… more
    AmeriHealth Caritas (06/03/25)
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  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization more
    CDPHP (08/03/25)
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  • Utilization Review Nurse

    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 ... Utilizes available resources to promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for… more
    US Tech Solutions (07/31/25)
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  • Registered Nurse - Utilization

    Ascension Health (Baltimore, MD)
    …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (05/17/25)
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