- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) responsible for ... Utilization Review Nurse and Utilization Review Specialist Nurse...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is ... responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD)… more
- HonorHealth (AZ)
- …different here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors ... Degree in Nursing from an accredited NLN/CCNE institution RequiredExperience3 years Registered Nurse in an acute care setting. Required1 year… more
- HonorHealth (AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... Nurse in an acute care setting - Required Licenses and Certifications + Registered Nurse ( RN ) State And/Or Compact State Licensure - Required +… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence...regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse -… more
- St. Peters Health (Helena, MT)
- …and utilization review over-site. 1. Utilization Review Specialist : receives information from the RN assigned to the ED related to admission ... with the patient/family, physicians, and the interdisciplinary team, the Case Management/ Utilization Review RN facilitates the patient's progress… more
- AdventHealth (Orlando, FL)
- …Services in the verification process. Obtains pre-authorization and provides information to the Utilization Review Specialist , Utilization Review ... Control RN Tier 1 is a professional registered nurse functioning withing Mission Control in...and placement of all patients. Proactively initiates steps, including utilization of the hospital and physician chain of command,… more
- Children's Mercy Kansas City (Kansas City, MO)
- …Oversees and directs the work of Nurse Case Managers, Social Workers, and Utilization Review specialist team members and support staff + Analyzes, ... and related software applications and implementations. + Engages in utilization review committee. Qualifications + Master's Degree...Performance Improvement Leadership + One of the following: Licensed RN - MO, Registered Nurse … more
- St. Luke's University Health Network (Allentown, PA)
- …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for...experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse ( RN ) - Case...and continuity of care to prevent readmission. 35% C. Utilization Review : 1. Performs utilization ... Years in an acute care setting, case management or utilization review Req 1 Year of acute...acute case management/discharge planning experience Pref Licenses and Certifications RN - Registered Nurse Upon… more
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