• Utilization Review Nurse Supervisor…

    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 ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working in… more
    The County of Los Angeles (08/18/25)
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  • 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 ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
    The County of Los Angeles (06/28/25)
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  • Utilization Review Nurse

    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 ... concurrent medical record review for medical necessity and level of care using...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
    Houston Methodist (07/25/25)
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  • Clinical Review Nurse - Prior…

    Actalent (Eugene, OR)
    Job Title: Clinical Review Nurse - Prior Authorization Job Description This role involves analyzing all prior authorization requests to determine the medical ... Skills + Licensed Practical Nurse (LPN) or Registered Nurse (RN) certification. + Clinical review and prior authorization experience. + 2-4 years of prior… more
    Actalent (08/08/25)
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  • Remote Clinincal Review Nurse

    Actalent (Miami, FL)
    Job Title: Clinical Review Nurse Job Description As a Clinical Review Nurse , you will perform concurrent reviews to assess members' overall health, ... review the type of care being delivered, evaluate medical...Essential Skills + Proficiency in utilization management and utilization review + Experience with Interqual and Medicare + Expertise… more
    Actalent (08/08/25)
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  • Clinical Review Nurse Care Manager

    Children's Mercy Kansas City (Kansas City, MO)
    …of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, insurance ... and continued patient stays with Attending Physician, Physician Advisor, Inpatient Nurse Care Manager, and insurance/payer. + Collaborates with Revenue Cycle to… more
    Children's Mercy Kansas City (08/08/25)
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  • Utilization Review Nurse I

    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
    Centene Corporation (08/02/25)
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  • Clinical Review Nurse

    Actalent (Dallas, TX)
    Clinical Review Nurse (Utilization Management)100% Remote Job Description The role of the Utilization Management Nurse involves performing concurrent ... Perform concurrent reviews to assess member's overall health. + Review the type of care being delivered and evaluate...Skills + 2+ years of utilization management and utilization review expertise. + Experience in concurrent review more
    Actalent (08/08/25)
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  • 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 ... with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
    CDPHP (08/03/25)
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  • Utilization Review Specialist Nurse

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry ... and concurrent medical record review for medical necessity and level of care using...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
    Houston Methodist (08/16/25)
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