• Utilization Review Specialist…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts ... this position is able to cover a multitude of utilization review functions through point of entry,...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (11/02/25)
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  • NCCPAC Revenue Utilization Review

    Veterans Affairs, Veterans Health Administration (Middleton, WI)
    Summary The Revenue Utilization Review (RUR) nurse ...level degree in Nursing may have opportunity to become registered as a nurse with a state ... the Nurse Manager and ANM. The RUR nurse is an active member of the revenue cycle...improvements in patient care through systematic evaluation and analytical review of clinical information. Responsibilities Responsibilities of the RUR… more
    Veterans Affairs, Veterans Health Administration (11/25/25)
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  • Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
    Minnesota Visiting Nurse Agency (11/04/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (10/02/25)
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  • Medical Utilization Review

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …as assigned. Essential Qualifications * Current Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with state licensure. Must retain active and ... Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with… more
    Brighton Health Plan Solutions, LLC (11/22/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
    US Tech Solutions (10/17/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
    Albany Medical Center (11/25/25)
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  • Utilization Review Nurse

    US Tech Solutions (May, OK)
    …of experience as an RN . 1+ years of inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review . . MUST HAVE 1...months of Prior Authorization. Education: . Active and unrestricted RN licensure in state of residence **About US Tech… more
    US Tech Solutions (10/17/25)
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  • Utilization Review RN

    Community Health Systems (Naples, FL)
    Join us as a ** Registered Nurse ( RN ) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri ... and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews...patient-centered service and continuous improvement. **Licenses and Certifications** + RN - Registered Nurse -… more
    Community Health Systems (11/20/25)
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  • RN Utilization Specialist/…

    YesCare Corp (Brentwood, TN)
    …+ Assist in completion of special projects on an as needed basis. **Key Qualifications:** + Registered Nurse ( RN ) active license + No less than 5 years' ... lives through care and expertise. **Key Responsibilities:** + The nurse will focus on what's best for the patients...practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. +… more
    YesCare Corp (10/30/25)
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