• MaineCare Quality Review

    State of Maine, Bureau of Human Resources (Augusta, ME)
    MaineCare Quality Review Nurse Augusta , Maine , United States | Nursing | Full-time Apply by: May 15, 2025 Apply with Linkedin Apply Department of Health ... yes and you are licensed as a Registered Professional Nurse in the State of Maine, as issued by...your personal vehicle for work purposes. Minimum Qualifications: Registered Nurse and three (3) years of progressively responsible experience… more
    State of Maine, Bureau of Human Resources (05/03/25)
    - Related Jobs
  • Quality Management Clinical Nurse

    UCLA Health (Los Angeles, CA)
    Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient care and safety. In… more
    UCLA Health (03/12/25)
    - Related Jobs
  • Operating Room Quality Clinical…

    HCA Healthcare (Richmond, VA)
    …we encourage you to apply for our Operating Room Quality Clinical Nurse Coordinator opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a(an) Operating Room Quality Clinical Nurse Coordinator you want in your current role? We invest in what… more
    HCA Healthcare (04/16/25)
    - Related Jobs
  • Utilization Review Nurse (RN)

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team...Quality and Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP)… more
    Matrix Providers (04/29/25)
    - Related Jobs
  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the largest… more
    The County of Los Angeles (03/30/25)
    - Related Jobs
  • Utilization Review Nurse

    CDPHP (Albany, 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 ... physician-founded, member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York.… more
    CDPHP (05/09/25)
    - Related Jobs
  • Medical Bill Review Senior Nurse

    Zurich NA (Schaumburg, IL)
    Medical Bill Review Senior Nurse 123154 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL ... to customer inquiries quickly, accurately and in a professional manner. + Meet quality standards by adhering to Best Practices and participating in monthly peer … more
    Zurich NA (05/09/25)
    - Related Jobs
  • RN / Nurse Utilization Review

    Elevance Health (Woodbridge, VA)
    RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - Thursday, ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the...medical necessity. + Works with healthcare providers to promote quality member outcomes, optimize member benefits, and promote effective… more
    Elevance Health (05/03/25)
    - Related Jobs
  • Clinical Review Nurse

    Hackensack Meridian Health (Eatontown, NJ)
    …and follow up. + Review all new admission charts to ensure all quality indicators are completed at the initial encounter with the patient or within the five ... coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine that the coding… more
    Hackensack Meridian Health (05/03/25)
    - Related Jobs
  • Care Review Clinician, Prior Authorization…

    Molina Healthcare (Seattle, WA)
    …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or...Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
    Molina Healthcare (04/11/25)
    - Related Jobs