- Veterans Affairs, Veterans Health Administration (Fort Belvoir, VA)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (ie, Puerto...completed work may require routine or detailed higher level review depending upon the complexity of the duties involved.]… more
- Veterans Affairs, Veterans Health Administration (Syracuse, NY)
- …and record relevant] patient information. Completed work [should need] only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... the resident's condition. Completed work needs only a general review by a RN for technical soundness, appropriateness and...and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (ie, Puerto… more
- Albany Medical Center (Albany, NY)
- …environment. + Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or ... financial constraints. + Provides collaborative care management with the primary nurse in assessing for discharge planning needs, coordinating appropriate resources… more
- Emanate Health (Covina, CA)
- …and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management ... we must empower them. **Required Qualifications:** + Upon hire: Washington Registered Nurse License + 3 years of Nursing **Preferred Qualification:** + Bachelor's… more
- CVS Health (Columbus, OH)
- …the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role ... ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position offers the… more
- Ascension Health (Tulsa, OK)
- …and coordinate the activities and flow of work for the peer review program. + Collect, evaluate, and maintain practitioner-specific data concerning physician and ... risk-related data. + Coordinate the medical staff's professional performance evaluation and peer review programs in a manner that fulfills the mission and goals of… more
- Ascension Health (St. Charles, IL)
- **Details** + **Department:** Utilization Review + **Schedule:** Part-Time, Partially Remote, Monday - Friday; 9am - 1pm. + **Hospital:** Ascension Saint Joseph + ... health care services regarding admissions, case management, discharge planning, and utilization review . + Review admissions and service requests within assigned… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and ... inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health plan and/or… more