- Community Health Systems (Naples, FL)
- …401k match & more available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, ... Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is… more
- BJC HealthCare (St. Louis, MO)
- …of RN experience performing care for hospitalized patients + 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity + ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization … 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 ... protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices....support and review of medical claims and utilization practices. Complete medical necessity and level of care… more
- Waystar (Atlanta, GA)
- …end user adoption of best practice workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a member of the Customer...acute care setting + 2+ years of experience in utilization management + Knowledge and understanding of Utilization… more
- Beth Israel Lahey Health (Burlington, MA)
- …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized… more
- Providence (Olympia, WA)
- **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... + Bachelor's Degree or Associate's Degree in Nursing + 3 years - Utilization Review , Care Management, Quality Management, and/or Discharge planning **Why Join… more
- Sanford Health (Rapid City, SD)
- …patient wellness through evidenced based practice, improved care outcomes, efficient utilization of health services, and appropriate level of care for patients ... and standards of nursing practice as outlined in the Nurse Practice Act and Administrative Rules in state of...is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Incumbent must obtain and… more
- Actalent (Rancho Cordova, CA)
- Job Title: Utilization Review Nurse Job Description The Registered Nurse will review cases for medical necessity across all levels of care, ensuring ... that patients receive appropriate and necessary treatment. Responsibilities + Review medical cases for necessity at all levels of care. + Utilize strong clinical and… more
- Lawrence General Hospital (Lawrence, MA)
- …appropriate referrals and facilitates appropriate discharge plans. + Works in conjunction with Utilization Review Nurse , Social Worker and Clinical Care ... an acute care setting with discharge planning, continuing care, care management, and utilization review . + Five years clinical nursing experience required +… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. ... documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established… more