- 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 ... correct payer source for hospitalization and communication. Ensures compliance of utilization review practices as required by payers, external regulatory agencies,… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …Salary Range $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed nursing professional responsible ... reviewing UM cases and discharge planning activities. The UM Nurse may also assist with preparing files for audits...MSO Case Management team and PCPs to ensure resource utilization is appropriate; plans and implements strategies to reduce… more
- Zenex Partners (Santa Rosa, CA)
- Description Job Opportunity: Registered Nurse - Utilization Review Facility: Providence Santa Rosa Memorial Hospital - Case Management Location: Santa Rosa, CA ... Employment Type: Travel/Contract Shift: Day (5x8 Hours) 8:00 16:30 Start Date: 3/3/2025 Job Duration: 13 weeks Compensation: Rate Type: Hourly Over Time: 8 regular hours in a day OR 40 regular hours in 1 week: 1.3% Double Time: None On-Call: 15$ Call Back:… 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 profound ... an employee but as a person. As a registered nurse (RN) joining our team, you're embracing a vital...the responsibilities involved in monitoring adherence to the hospital's utilization review plan, which ensures the appropriate use of… more
- 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 Cottage Health...Responsibilities include: The manager's primary responsibility is to oversee utilization review functions and to ensure accurate patient status… more
- AmeriHealth Caritas Health Plan (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring ... overtime, and weekends based on business needs Responsibilities Conduct utilization management reviews by assessing medical necessity, appropriateness of care,… more
- Ascension (Wichita, KS)
- Details Department: Utilization Management Schedule: Full-time, Day Shift, 40 hours/week, Monday-Friday, 8am-4:30pm Location: Wichita, KS - Must be located within ... health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit… more
- McLaren Health Care Corporation (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/. Position Summary: This position is responsible for utilization management functions. This includes but is not limited to review… more
- BRISTOL HOSPITAL GROUP (Bristol, CT)
- …Time Education Level 4 Year Degree Job Shift 1st Shift (Days) Description Registered Nurse Utilization Reviewer At Bristol Health, we begin each day caring today ... criteria sets used to support medical decision making. The appropriate Nurse Utilization Reviewer will have a strong working knowledge of nationally recognized… more
- Medical Solutions (Omaha, NE)
- A 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, travel… more
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