- US Tech Solutions (Columbia, SC)
- …the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) **About US Tech ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more
- BriteLife Recovery (Englewood, NJ)
- …assigned What we need from you? + Minimum of 2-3 years of experience in utilization review , case management , or insurance coordination in a behavioral health ... What you will be doing? The Utilization Review (UR) Specialist is a...Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols. + Monitor trends in… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...preferably in a hospital setting + 2+ years of utilization management experience in a health plan… more
- US Tech Solutions (Chicago, IL)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF ... Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in...+ Do you have experience with Utilization Review ? + Do you have an Active Registered… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... Requirement :** **Minimum Experience Requirement :** Minimum of three years of utilization management experience. Experience in quality- related job preferred.… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the...Identify care coordination needs and refer cases to case management as appropriate Qualifications + Active CA RN ... Role We're looking for a Utilization Review (UR) Nurse to join our team...2-3 years of clinical experience in prior authorization, case management , or utilization management +… more
- US Tech Solutions (May, OK)
- …MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1 YEAR OF ... . 1+ years of inpatient hospital experience . Registered Nurse in state of residence ....UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. . MUST HAVE… more
- TEKsystems (Los Angeles, CA)
- …for a Licensed Vocational Nurse (LVN) or Registered Nurse ( RN ) with hands-on experience in Utilization Management (UM) and a strong understanding ... Location: West Hills/Canoga Park 91305 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer... license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with… more
- Actalent (Houston, TX)
- "Urgent Hiring for " Utilization Review RN " Job...utilization management and utilization review /managed care/hospital setting as an RN is ... Perform concurrent reviews to assess member's overall health. + Review the type of care being delivered and evaluate...& ICU Hospital expereince is Mandatory + Active Compact RN license is Mandatory If you are Interested ,… more
- UNC Health Care (Kinston, NC)
- …clinical experience as a Registered Nurse required. + 2 years utilization review , care management , or compliance experience preferred. + Minimum 1 ... to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying… more