- 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 NURSE ... regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team....provided to patients are appropriate and covered by the insurance payer. They are responsible for ensuring that patient… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the ... Patient Accounting Centers (CPAC) for revenue reimbursement. The RUR nurse applies advanced clinical knowledge, communication skills, and collaboration to… 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 ... review of relevant medical documentation, medical guidelines, and insurance benefits and communicates information to payers in accordance with contractual… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 PM ... and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to...- Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and… more
- Children's Mercy Kansas City (Kansas City, MO)
- …lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, ... status and continued patient stays with Attending Physician, Physician Advisor, Inpatient Nurse Care Manager, and insurance /payer. + Collaborates with Revenue… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Utilization Review Nurse I provides first level clinical review ... requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care… more
- Ascension Health (Pensacola, FL)
- **Details** + **Department: Utilization Review ** + **Schedule: PRN rotating shifts** + **Hospital: Ascension Sacred Heart Pensacola** + **Location: Pensacola, ... last up to 90 days** **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term… more
- New York State Civil Service (New York, NY)
- NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , P26749 ... Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily Utilization … more
- UNC Health Care (Kinston, NC)
- …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, ... movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as… more
- Centene Corporation (New York, NY)
- …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers on utilization… more