- Harris Regional Hospital (Sylva, NC)
- …the multidisciplinary team, payors, and community resources; leads discharge planning and utilization review activities. Reports to the Director or Manager of ... Registered Nurse (RN) - Case Manager Schedule: PRN, As...Protected Health Information Accessed: Demographic, Clinical, Insurance, Financial, Complete Medical Record. Exposure: Occupational exposure to bloodborne pathogens may… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, ... changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION II: ... UTILIZATION REVIEW NURSE SUPERVISOR...for medical care evaluation studies. + Attends Utilization Review Committee meetings to inform the… more
- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- Summary The Orlando VA Medical Center is seeking a Utilization Review Registered Nurse to join the Orlando VAMC team. The Utilization Review ... improvement and outcomes utilization consultation. Responsibilities The Utilization Review Registered Nurse leads the integration of evidence-based… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II...over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of ... entry and concurrent medical record review for medical ...this position is able to cover a multitude of utilization review functions through point of entry,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …*_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the medical necessity, appropriateness, and ... The RN conducts timely reviews of inpatient and outpatient medical records to determine the appropriateness of admissions, continued... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse (37.5...third-party administrator files to oversee contractor handling; + May review medical records of various health care ... (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) is now hiring for the position of Utilization Review Nurse (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5612XC&R1=&R3=) to… more
- YesCare Corp (Brentwood, TN)
- …standards of best practice. + Facilitate quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and ... lives through care and expertise. **Key Responsibilities:** + The nurse will focus on what's best for the patients...review parameters under the direction of the YesCare Medical Director. + Identify and document comparisons with community… more
- University of Utah Health (Salt Lake City, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
