- Georgetown Behavioral Health Institute (Georgetown, TX)
- …a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator. This position is responsible for working with ... access the full range of their benefits through the utilization review process. Requirements + Education: Master's...LMFT or LMFT-A Preferred but not required. LVN or RN licensure also considered for this position. + Experience:… 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 ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity… more
- Cedars-Sinai (Los Angeles, CA)
- …Hearing, Repetitive Motions, Eye/Hand/Foot Coordination **Req ID** : 14355 **Working Title** : Registered Nurse - Utilization Review Case Manager - ... America's Best Hospitals. Summary of Essential Duties: + The Utilization Management (UM) Registered Nurse ...accordance with CMS requirements and payer timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners… more
- Centene Corporation (Harrisburg, PA)
- …Health Professional (LMHP) required or + Board Certified Behavior Analyst (BCBA) required + RN - Registered Nurse - State Licensure and/or Compact State ... Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with...Licensure RN - Registered Nurse - State Licensure and/or Compact State… 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 year ... to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital ... Utilization Review Program and makes appropriate referrals to designated Physician...A. Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed… more
- Prime Healthcare (Lynwood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/237903/ rn -case-manager utilization - ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...an accredited school of nursing and a current state Registered Nurse license.2. Grandfathered prior to April… more
- PeaceHealth (Eugene, OR)
- **Description** PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. ... strong psychiatric nursing background and previous admission coordination experience + Required: Registered Nurse in state of practice + Preferred: Psychiatric… more
- WestCare Foundation (Henderson, NV)
- … RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or ... substance use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10… more
- 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