• Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... the requirements and guidelines for an effective and timely utilization review system . + Confers...the County of Los Angeles, a Utilization Review Nurse is an RN more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II...Review organization requirements for an effective and timely utilization review system . + Directs the ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.88… more
    The County of Los Angeles (06/28/25)
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  • Registered Nurse

    Beth Israel Lahey Health (Boston, MA)
    …people's lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts +… more
    Beth Israel Lahey Health (09/10/25)
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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 (09/05/25)
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  • Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to… more
    Community Health Systems (09/03/25)
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  • Registered Nurse 1 Psychiatric (NY…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , ... York State NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily … more
    New York State Civil Service (08/14/25)
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  • Utilization Review RN PRN

    Saint Luke's (Kansas City, MO)
    **Job Description​** The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through ... utilization review and management. This position includes...billing. **Job Requirements** Applicable Experience: Less than 1 year Registered Nurse - Various Associate Degree **Job… more
    Saint Luke's (08/21/25)
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  • Registered Nurse

    HonorHealth (AZ)
    …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... together. HonorHealth is one of Arizona's largest nonprofit healthcare systems , serving a population of five million people in...in an acute care setting - RequiredLicenses and Certifications Registered Nurse ( RN ) State And/Or… more
    HonorHealth (08/22/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
    US Tech Solutions (07/18/25)
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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... education with members and providers regarding health care delivery system , utilization on networks and benefit plans....the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse more
    US Tech Solutions (07/31/25)
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