- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to...new staff to Federal laws and regulations pertaining to Medicare and Medi-Cal reimbursement. + Analyzes cases for referral… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... this position is able to cover a multitude of utilization review functions through point of entry,...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -...a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid,… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Command Center at the Emory Northlake campus. Monday-Friday** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting ... both patient and hospital. + Will identify and complete Medicare Outpatient Observation Notices (MOON), Medicare Change...experience or a minimum of two years of previous utilization review experience. + Must have a… more
- New York State Civil Service (New York, NY)
- …Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , P26749 Occupational Category Health Care, Human/Social Services ... Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... to hire) **Job Description:** + NICE TO HAVE skill sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral… more
- US Tech Solutions (Chicago, IL)
- …MANAGED CARE exp and Medicare /Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1 YEAR OF UTILIZATION ... with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an...Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions… more
- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Intermountain Health (Murray, UT)
- …FEHB, Marketplace Qualified Health Plans, fully funded and self-funded Commercial plans. Utilization Review nurses at Select Health proactively oversee inpatient ... and outpatient utilization to assure that care related to health insurance...applicable regulatory guidelines (NCQA, CMS, State) and ensures timely review with clear accurate communication to members and requesting… more