- Cottage Health (Goleta, CA)
- Job Description Cottage Health seeks a Utilization Review Manager, Registered Nurse for their Clinical Denials and Appeals department responsible for the ... overall management of utilization review processes and clinical denials between...Preferred: 2 years direct patient care experience as an RN in an acute care setting. About Us Cottage… more
- American Traveler (Madison, WI)
- American Traveler is seeking an experienced RN Case Manager for a daytime rehab utilization review position requiring an active RN license and two years ... in a rehabilitation hospital setting, *Role is within the Utilization Review department, *Day shift schedule from...shift schedule from 08:00 to 16:30, Job Requirements *Active RN license required at time of consideration, *A minimum… more
- American Traveler (Roseville, CA)
- …prior to consideration, Additional Information *Responsible for comprehensive case management, utilization review , and coordination of care within an integrated ... American Traveler is seeking an experienced RN Case Manager with at least 2 years...*Must have a broad knowledge base of healthcare delivery, utilization review , observation status, and post-acute levels… more
- Medical Solutions (Omaha, NE)
- …facility in Port Charlotte, FL is seeking its next amazing RN ( Registered Nurse ) to work in Case Management ( Utilization Review ). Read on if this ... sounds like your perfect fit! Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you where you want to go - personally and professionally. Wherever you may roam,… more
- EvergreenHealth (Kirkland, WA)
- …provides intervention to facilitate patient care in an optimal timeline. Oversees utilization review process including education, support, and training of team ... for equipment, and arrange for additional services in the community. Utilization Management/Case Management Nurses provide clinical information to our payers and… more
- Ascension (Wichita, KS)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . Review admissions and service requests within ... planning needs with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversee and coordinate compliance to… more
- AmeriHealth Caritas Health Plan (Washington, DC)
- …home health care, or medical office setting Licensure Current driver's license required A Registered Nurse ( RN ) license in the District of Columbia in ... to efficiently document and assess patient cases Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
- UHS (Temecula, CA)
- …Southwest Healthcare Regional office in Temecula, CA is seeking a Full-Time RN Central Utilization Review Nurse who will be responsible for carrying out ... ensure correct payer source for hospitalization and communication. Ensures compliance of utilization review practices as required by payers, external regulatory… more
- Zenex Partners (Santa Rosa, CA)
- Description Job Opportunity: Registered Nurse - Utilization Review Facility: Providence Santa Rosa Memorial Hospital - Case Management Location: Santa ... Rosa, CA Employment Type: Travel/Contract Shift: Day (5x8 Hours) 8:00 16:30 Start Date: 3/3/2025 Job Duration: 13 weeks Compensation: Rate Type: Hourly Over Time: 8 regular hours in a day OR 40 regular hours in 1 week: 1.3% Double Time: None On-Call: 15$ Call… more
- Lifepoint Health (Louisburg, NC)
- Description Registered Nurse ( RN ) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a ... as an employee but as a person. As a registered nurse ( RN ) joining our...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate… more
