- Baptist Memorial Health (Southaven, MS)
- …and/or life situation. Performs other duties as assigned. Responsibilities * Utilization Review * Discharge planning * Readmission Reduction Participation ... of patients throughout the continuum of care for appropriate utilization of resources, service delivery and compliance with federal...Manager Facility: BMH - Desoto Hospital Department: DC Case Management Admin BMH Desoto Category: Nurse RN… more
- UCLA Health (Los Angeles, CA)
- Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards,...+ A minimum of three years of experience in utilization management , preferred + Team leading or… more
- The County of Los Angeles (Los Angeles, CA)
- …may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience whose primary charge is ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...of Los Angeles, a Utilization Review Nurse is an RN that has Case Management … more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- **12/2/2025 - REVISED FTE *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / ... needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for… more
- Veterans Affairs, Veterans Health Administration (Smyrna, TN)
- …of functions, and the integration of VHA and industry best standards. The Revenue Utilization review (RUR) Registered Nurse (RN) is an active member ... will be accepted and considered.** Responsibilities of the RUR nurse include, but are not limited, to the following:...5 years nursing experience. 1-3 years of relevant case management or utilization review experience.… more
- George C. Grape Community Hospital (Hamburg, IA)
- Quality/ Utilization Review Nurse Position Summary: The Quality/ Utilization Review Nurse is responsible for evaluating the medical necessity, ... years of clinical nursing experience (acute care preferred). o Prior experience in utilization review , case management , quality improvement, and infection… more
- University of Utah Health (Salt Lake City, UT)
- …their scope of practice and according to state law. **Required** + One year ** Utilization Review or Case Management ** experience. **Corporate Overview:** The ... a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management ...Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one… more
- Emory Healthcare/Emory University (Decatur, GA)
- …mentorship, development,leadership programs and more! **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for ... extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department's...experience or a minimum of two years of previous utilization review experience. **Licensure -** Must have… more
- Huron Consulting Group (Chicago, IL)
- … Utilization Review Plan and the overall operation of the Utilization Management Department in accordance with federal, state and local guidelines, ... are now and create your future. The Manager of Utilization Management is responsible for planning, organizing,...+ Staff Acquisition and Support: Leads and manages the utilization review staff and function for the… more
- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse is responsible for ensuring the receipt of high ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...RN, preferably in a hospital setting + 2+ years Utilization Management experience in a health plan… more
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