- Centene Corporation (Richmond, VA)
- …- 5pm Eastern with some holidays on a rotating basis.** + **Previous concurrent review experience is highly preferred.** **Position Purpose:** Performs ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife-PD Days-MMG Concurrent -Jersey City-NJReq #:0000192616 Category: Nurse Midwife Status:Per Diem Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Pay Range:$94.76 per hour Location: 355 Grand Street,...355 Grand Street, Jersey CIty, NJ 07302 Job Title: Nurse Midwife Location: Jersey City Medical Center Department: MMG… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receives and reviews notification of emergent hospital admissions, completes inpatient concurrent review , establishes discharge plans, coordinates transitions of… more
- Beth Israel Lahey Health (Boston, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on… more
- Idaho Division of Human Resources (Nampa, ID)
- Utilization Review and Nurse Educator - SHW Posting Begin Date: 2025/09/22 Posting End Date: 2025/10/20 Category: Nursing Work Type: Full Time Location: Nampa, ... Idaho! We are currently seeking a dedicated and experiencedRegistered Nurse Seniorto take on a critical role in our...Seniorto take on a critical role in our Utilization Review , Performance Improvement, Nursing Education programs. This is an… more
- CDPHP (Latham, NY)
- …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 ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- Actalent (Sunrise, FL)
- Job Title: Behavioral Health Utilization Review NurseJob Description The Utilization Management Nurse (UMN) plays a crucial role in reviewing requests for ... with the interdisciplinary team, the UMN handles tasks related to utilization review across various specialties, medical treatments, and services. The role involves… more
- Dayton Children's Hospital (Dayton, OH)
- Facility:Dayton Children's - Main CampusDepartment:Utilization Review TeamSchedule:Full timeHours:40Job Details:Under the supervision of the Manager of Utilization ... Management, the Utilization Review RN conducts medical record review for...and collaborates with the Denials team assisting to prevent concurrent and retrospective denials. The Physician Advisor role will… more
- UNC Health Care (Kinston, NC)
- …assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of ... the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care,… more
- University of Utah Health (Salt Lake City, UT)
- …continued stay review . + Communication to third-party payers for initial and concurrent clinical review . + Reviews patient chart to ensure patient continues ... cost, or over/under-utilization of resources. + Performs verbal/fax clinical review with payer as determined by nursing judgment and/or...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
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