• Medical Review Unit Director…

    Rising Medical Solutions (Chicago, IL)
    …in stakeholder communication regarding program objectives, outcomes, and revisions. Requirements + Registered Nurse ( RN ) with an active and unencumbered ... Rising Medical Solutions seeks a Medical Review Unit Director for our...communication skills. + Proficient in the use of electronic medical record (EMR) systems and Microsoft Office… more
    Rising Medical Solutions (06/28/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Dover, DE)
    …without personal distractions to meet quality and metric expectations. **Required Qualifications** + Registered Nurse ( RN ) - active license. + 3+ Years ... skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. Applies the appropriate clinical criteria/guideline and… more
    CVS Health (08/01/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will be responsible for providing ... **Essential Duties & Responsibilities:** + Primary responsibility for performing daily medical reviews, appeals as appropriate, correspondence regarding review more
    Commonwealth Care Alliance (06/27/25)
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  • Utilization Review Nurse (40 Hour)

    State of Connecticut, Department of Administrative Services (New Haven, CT)
    …monitor agency and third-party administrator files to oversee contractor handling; + May review medical records of various health care eligibility, resource ... Utilization Review Nurse (40 Hour) Office/On-Site Recruitment...(https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to… more
    State of Connecticut, Department of Administrative Services (07/23/25)
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  • Flight Registered Nurse ( RN

    Vighter Medical Group (Jacksonville, FL)
    Flight Registered Nurse ( RN ), Jacksonville, FL Job...to their countries of origin. The RN will review medical records to determine if ... - Jacksonville, FL Position Type Full Time Education Level Registered Nurse ( RN ) Salary Range...Customs Enforcement. Healthcare is delivered in accordance with approved medical protocols and in compliance with Department of Homeland… more
    Vighter Medical Group (07/01/25)
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  • Utilization Review Specialist RN

    Houston Methodist (Sugar Land, TX)
    registered nurse ( RN ) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care ... determines the appropriateness of inpatient or observation services following review of relevant medical documentation, medical...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/29/25)
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  • Utilization Review Services RN

    HCA Healthcare (Nashville, TN)
    …geographical market and productivity. **What you will do in this role:** + Conduct medical record review , validate admission status order, conduct a ... and mitigation of concurrent denials. This involves assessing the medical record for appropriateness and level of...+ 1 - 4 years of relevant case management/utilization review experience preferred + Registered Nurse more
    HCA Healthcare (08/03/25)
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  • Utilization Review Nurse

    Houston Methodist (Houston, TX)
    registered nurse ( RN ) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care ... Houston Methodist, the Utilization Review Nurse (URN) position is a licensed ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/25/25)
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  • RN Registered Nurse

    Henry Ford Health System (Grand Blanc, MI)
    Registered Nurse - Medical ...tests ordered are expeditiously carried out and documented. + Review patient medical record /reports and ... will be considered the official job description. Education/Experience Requirements + Licensed Registered Nurse credentialed from the Michigan Board of Nursing… more
    Henry Ford Health System (06/23/25)
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  • Registered Nurse I, RN I…

    State of Colorado (Golden, CO)
    Registered Nurse I, RN I...(DYS) policy. Documents all encounters with youth in electronic medical records system and/or appropriate medical ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5019028) Apply  Registered Nurse I, RN I -… more
    State of Colorado (07/25/25)
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