- Martin's Point Health Care (Portland, ME)
- …Point 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 ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...and offerings. Education/Experience: + Unrestricted state license as a Registered Nurse required; BSN preferred. + 3+… more
- Dartmouth Health (Lebanon, NH)
- Overview Utilization Review Per Diem - Remote Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. ... skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote :Fully Remote * Area of Interest:Nursing * Pay… more
- AdventHealth (Tampa, FL)
- …diseases. **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...experience. Current and valid license to practice as a Registered Nurse (ADN or BSN) required. Minimum… more
- University of Washington (Seattle, WA)
- … is responsible for maintaining the knowledge and skill set related to utilization review , care coordination, and performance improvement, while working in a ... Center - Montlake** has an outstanding opportunity for **a Utilization Management Nurse .** **POSITION HIGHLIGHTS** The goal...referral system + Current license to practice as a registered nurse in the State of Washington… more
- St. Luke's University Health Network (Allentown, PA)
- …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... outpatient denials for experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment of claims. JOB… more
- Ochsner Health (New Orleans, LA)
- …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse ( RN ) Case Manager...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
- Idaho Division of Human Resources (ID)
- Senior Registered Nurse ( RN ) - MED Posting Begin Date: 2025/08/19 Posting End Date: 2025/09/16 Category: Nursing Work Type: Full Time Remote : Flexible ... Health and Welfare has an exciting opportunity for aRegistered Nurse Senior ( RN )with the Bureau of Clinical...for this position. + Licensed as a Professional or Registered Nurse in Idaho as defined by… more
- CVS Health (Juneau, AK)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- US Tech Solutions (Columbia, SC)
- **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + Hours/Schedule - M-F 8:30am - 5pm. + Onsite training for the ... first week. Remote once training is complete. + A typical day...to determine the priority of our cases. Then we review the requests against the policy and the member's… more
- Veterans Affairs, Veterans Health Administration (Manchester, NH)
- Summary This Registered Nurse - Community Hospital Navigator is located within the Case Management Dept at the Manchester, NH VA location. This position is full ... year of discharge care coordination experience. Case Management experience preferred. Have been a Registered Nurse for at least 3 years. 2+ years of acute… more