- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively ... this position is able to cover a multitude of utilization review functions through point of entry,...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Utilization Review Specialist **Cost Center:** 101651289 Revenue Cycle ... (United States of America) **Job Description:** **JOB SUMMARY** The Utilization Review Specialist , Revenue Cycle...as a Licensed Practical Nurse (LPN). **Preferred/Optional:** Registered Nurse ( RN ). **EXPERIENCE** **Minimum… more
- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… 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 Summary The Utilization Review RN Specialist reviews and monitors ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
- Actalent (Sunrise, FL)
- …Health Utilization Review SpecialistJob Description The Behavioral Health Utilization Review Specialist conducts comprehensive utilization ... review with hospitals and mental health centers. The specialist is responsible for planning discharges and aftercare, and...LMHC). + Minimum of two years of experience in utilization review /case management. + At least one… more
- Catholic Health Initiatives (Omaha, NE)
- **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize ... Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive reviews of… 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
- Commonwealth Care Alliance (Boston, MA)
- …for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting centralized ... reviews). * Hire, train and mentor UM staff, including nurse reviewers and support personnel. * Act as liaison...Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent… 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
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