- Premera Blue Cross (Mountlake Terrace, WA)
- …of different claim types is desired. (Preferred) + Current Washington State License: Registered Nurse ( RN ), Advanced Registered Nurse ... medical policy changes, and coding changes. + Research and interpret medical claims utilization and program participation. Present findings to internal… more
- Stanford Health Care (Palo Alto, CA)
- …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... while identifying instances of overpayments and underpayments. Proficiency in healthcare claims analysis, including the ability to review , interpret, and… more
- Terumo Medical Corporation (Baltimore, MD)
- …Date: Nov 20, 2025 Req ID: 5264 Location: Baltimore, MD, US Company: Terumo Medical Corporation Department: TIS Sales - Mid Atlantic Terumo Medical Corporation ... (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous… more
- Terumo Medical Corporation (Tampa, FL)
- …Date: Oct 31, 2025 Req ID: 5128 Location: Tampa, FL, US Company: Terumo Medical Corporation Department: TIS Sales - South Florida Terumo Medical Corporation ... (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous… more
- Stanford Health Care (Palo Alto, CA)
- …to leaders and team members on leave policies and practices, including claim filing process; act as liaison betweenteam members, leaders, Benefits, Payroll, WHW ... Leave Team to resolve leave issues; provide follow-up with teammembers on claims , payments and related worker's compensation issues. In collaboration with leader and… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …may include preauthorization, outpatient and inpatient management, case management, retrospective claim review , and delegated management oversight. + Participate ... that they are operating effectively. **What You'll Bring:** + Candidates with a RN License are highly preferred. + Current state credential (eg licensure) that… more
- Houston Methodist (Houston, TX)
- …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 ...and/or case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Ascension Health (Tulsa, OK)
- …processes and procedures. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing ... claims , qualityindicators and other risk-related data. + Coordinate the medical staff's professional performance evaluation and peer review programs in… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and...customer service skills required. **Minimum License Requirement :** California RN license. Delivering world-class health care one patient at… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will ... any questions you may have. Job Duties * Perform medical review /authorization process. * Ensure coverage for...Perform other duties as assigned. Minimum Qualifications * Current Registered Nurse / RN license… more
