• Utilization Review , Management…

    Sutter Health (Sacramento, CA)
    …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... health care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical… more
    Sutter Health (05/29/25)
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  • Hospitalist Nurse Navigator

    Billings Clinic (Billings, MT)
    …and coordinates care with the RN Care Manager, Social Services Care Manager, Utilization Review RN, Physician Advisor and Care Management Assistant. ... here. About Us Billings Clinic is a community-owned, not-for-profit, Physician -led health system based in Billings with more than...high risk for readmission. * Interfaces effectively with the Utilization Review department to stay current on… more
    Billings Clinic (06/03/25)
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  • Physician Advisor

    Hackensack Meridian Health (Brick, NJ)
    …Engage in the teaching, consulting and advising of the care management and utilization review departments and hospital leadership. + Collaborate with a ... . + Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is **preferred** . + Physician more
    Hackensack Meridian Health (04/22/25)
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  • Utilization Management Physician

    Intermountain Health (Las Vegas, NV)
    …1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review , quality ... with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management, care management, claims, network management, and finance. As the… more
    Intermountain Health (06/03/25)
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  • 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 ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician more
    The County of Los Angeles (03/30/25)
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  • Utilization Review Specialist Nurse

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… more
    Houston Methodist (06/21/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
    Commonwealth Care Alliance (06/27/25)
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  • Utilization Review Intake RN…

    AdventHealth (Glendale Heights, IL)
    …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use...the UM nurse is responsible for escalation to the Physician Advisor or designated leader for additional review more
    AdventHealth (06/13/25)
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  • Utilization Review Nurse - Emergency…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... determinations + Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare, Medicaid, and Managed… more
    Houston Methodist (06/06/25)
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