- Glens Falls Hospital (Glens Falls, NY)
- …hours per week, can be foundhere. **Job:** **Nursing - Case Management* **Title:** *Registered Nurse - Utilization Review Nurse - Care Management (Sign-On ... timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing… more
- Justice, Bureau of Prisons/Federal Prison System (Fort Worth, TX)
- …Care Level 3 facility, or Federal Correctional Complex (FCC). Serves as the Utilization Review Nurse and assists in quality improvement activities through data ... the appropriateness of medical care and communicates findings to the Utilization Review Committee. Applies predetermined evidence-based criteria sets and clinical… more
- Insight Global (Philadelphia, PA)
- …A Healthcare Insurance company local to Philadelphia PA is looking to hire a Utilization Management Nurse (RN) to their delegation oversight & assessment team. ... Active NJ or PA RN license 2+ years of experience working in Utilization Review or Utilization Management with commercial payers or medicare/medicaid… more
- Cleveland Clinic (Cleveland, OH)
- …with one of the most respected healthcare organizations in the world. As a Utilization Review Nurse , you will provide clinical information to insurance companies ... two times per month. The ideal future caregiver is someone who: + Is a Registered Nurse (RN). + Has two to three years of nursing experience in a med/surg, ICU, or… more
- Adecco US, Inc. (Dallas, TX)
- We are currently seeking a ** Utilization Management Nurse ** in **Dallas, Texas** . If you want to join our team, apply today! We offer competitive salary range ... in an acute care hospital setting required. + Minimum of two years Utilization Management acute care setting experience required. + Minimum of one year drafting… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and ... Eastern Standard Time Holiday rotation 1-2 per year. CCR - Duals UM Nurse ConsultantUtilizes clinical experience and skills in a collaborative process to assess,… more
- CVS Health (Columbus, OH)
- …deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote and ... 1-2 per year. Position Summary CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a...to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... acute care experience is required as a Licensed Practical Nurse . + Minimum of two (2) years Utilization... Nurse . + Minimum of two (2) years Utilization Management experience is preferred. + Knowledge of coding/claims… more
- CVS Health (Lansing, MI)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and ... can live in any state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a...to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Role BHPS provides Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal reviews and clinical quality ... DME, and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse (RN) with state licensure. Must retain active and unrestricted licensure… more