- Martin's Point Health Care (Portland, ME)
- …preferred + 3+ years of medical management experience in a managed care setting including utilization review + RN experience in a clinical setting + ... The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas...Required License(s) and/or Certification(s): + Current Licensure as an RN in Maine and other appropriate jurisdictions as necessary… more
- Providence (Mission Hills, CA)
- **Description** ** RN Utilization Review - Remote . This position will work full- time in a 8-hr Day shift.** Provide prospective, retrospective, and ... must empower them. **Required Qualifications:** + Associate's Degree in Nursing. + California Registered Nurse License upon hire. + 2 years of experience working… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...+ 3+ years of clinical nursing experience as an RN , preferably in a hospital setting + 2+ years… more
- Providence (Irvine, CA)
- **Description** ** RN Utilization Review at Irvine, CA. This position is Full- time and will work Remote 8-hour, Day shifts.** Provide prospective, ... must empower them. **Required Qualifications:** + Associate's Degree Nursing. + Upon hire: California Registered Nurse License + 2 years experience working in a … more
- CVS Health (Frankfort, KY)
- …it all with heart, each and every day. **Position Summary** This is a fully ** remote ** Utilization Review Clinical Consultant. **Must reside in the state of ... Kentucky state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active...schedule based on business needs **Preferred Qualifications** + Managed care/ utilization review experience + Foster Care population… more
- Dartmouth Health (Lebanon, NH)
- …communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote :Fully Remote * Area ... of Interest:Nursing * Pay Range:$79,747.20/Yr. - $127,587.20/Yr. (Based on 40 hours per week, otherwise pro rata) * FTE/Hours per pay period:.01 hrs/per week (per diem/temp) * Shift:Rotating * Job ID:35880 Dartmouth Health offers a total compensation package… more
- Cognizant (Salem, OR)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,… more
- BJC HealthCare (St. Louis, MO)
- … RN experience performing care for hospitalized patients + 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity + ... team! This is a great opportunity for a local remote position. There is no communication with patients. This...Must have at least one active MO or IL RN license + If candidate only has one … more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or… more
- Banner Health (AZ)
- …and innovative employment options by offering remote and hybrid work settings. The Registered Nurse RN Medical Management Services is required to be ... payers, community agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in the state of… more
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