- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Vighter Medical Group (Glendale, CO)
- …team at theOffice of Community Care (OCC)in Glendale, Colorado.As aCase Manager / Utilization Review Nurse , you'll play a key role in coordinating and ... Registered Nurse (RN) Glendale, CO Job Details Job Location...or on-call required. What You'll Do As a Case Manager / Utilization Review RN,...You'll Do As a Case Manager / Utilization Review RN, you will: + Conductclinical… 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 ... this position is able to cover a multitude of utilization review functions through point of entry,...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of ... Patient Accounting Centers (CPAC) for revenue reimbursement. The RUR nurse applies advanced clinical knowledge, communication skills, and collaboration to… 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** + ... of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of CMS Regulations. **Working… more
- Commonwealth Care Alliance (Boston, MA)
- 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy + Works… more
- Dignity Health (Chandler, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...five (5) years of nursing experience + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
- Dignity Health (Gilbert, AZ)
- …of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...five (5) years of nursing experience + Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a* Utilization Review Manager * to join ourTransitional Care Team.This is a full-time role and will be required to work ... to 5) years of professional leadership experience (ie, charge nurse , team leader, preceptor, committee chair, etc.) * Five...required or completed within three years of hire **Title:** * Manager - Utilization Review * **Location:**… more
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/233537/registered- nurse -case- manager ... KNAPP MEDICAL CENTER IS LOOKING FOR A PRN REGISTERED NURSE CASE MANAGER TO WORK WEEKENDS. WE...to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,… more