- Veterans Affairs, Veterans Health Administration (Winter Park, FL)
- …of care . Responsibilities The Community Care (CC) Utilization Review Registered Nurse ( RN ) is responsible for collecting, interpreting, ... care coordination for the VAHCS. The CC Utilization Review RN performs a...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Trinity Health (Athens, GA)
- **Employment Type:** Part time **Shift:** **Description:** The Utilization Review (UR) Coordinator works, in collaboration with a multidisciplinary team that ... payers, to ensure patients progress along the continuum of care in an efficient and cost-effective manner that ensures...management and auditing duties as assigned. Participates in the Utilization Review Committee as assigned. Maintains good… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- Utilization Review Nurse (40...care delivery and reimbursement systems; + Participates in utilization review and/or quality assurance programs; + ... (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to...care disciplines; + regulations and standards pertaining to utilization review ; + care and… more
- Guthrie (Binghamton, NY)
- …care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service requests ... with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and...a part of a tradition of excellence in health care . In all areas and at all levels of… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- CVS Health (Annapolis, MD)
- …state licenses + Ability to work rotating weekends **Preferred Qualifications** + Managed care / utilization review experience preferred + Acute care ... Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of… more
- Adecco US, Inc. (Minneapolis, MN)
- …the direct supervision of an RN or MD. . Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according ... ** : . Knowledge of Home Health processes. . Registered Nurse with a current license to...applicable states . 2+ years of experience in managed care , Utilization Review , Case Management… more
- Corewell Health (Royal Oak, MI)
- …to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - ... of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review...accredited school of nursing. + Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing… more
- CVS Health (Charleston, WV)
- …function. Required Qualifications: + Licensed independent Behavioral Health clinician or a Registered Nurse ( RN ) with unrestricted state license with ... experience in psychiatric setting required Preferred Qualifications: + Managed care / utilization review experience preferred +...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
- CVS Health (Madison, WI)
- … care **Preferred Qualifications** + NICU experience highly preferred + Managed care / utilization review experience + Ability to multitask, prioritize and ... Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of… more
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