- 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 and ... **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Adecco US, Inc. (Houston, TX)
- Adecco Healthcare & Life Sciences is assisting a client hire a Utilization Review Nurse in Houston, TX! This role is in person / on site. Please read below ... **Type:** Full time - direct hire with client! **Schedule:** Monday through Friday, 8am to 5pm **Pay:** $85,00 to...5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse :** . **… more
- Ascension Health (Baltimore, MD)
- …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... implement quality review programs and key performance indicators for all utilization review activities. + Interact with medical, nursing, and executive… more
- AmeriHealth Caritas (Dover, DE)
- …ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work Monday through Friday, 8:00 AM ... preferred. + An active OH or compact state Registered Nurse (RN) license in good standing is required. +...document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria,… more
- Ascension Health (Baltimore, MD)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... **Details** + **Department:** Utilization Management + **Schedule:** Part-time. Monday -Friday,...healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee… more
- BJC HealthCare (St. Louis, MO)
- … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity ... **Schedule** PRN (As needed) + Shifts will fall between Monday -Friday 8 am - 4:30 pm with assigned Sunday...medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and… more
- 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 ... **Job Description:** + Monday -Friday, 8am-4:30pm or 8:30am-5pm panel interviews on ms...promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate services within benefit… more
- AmeriHealth Caritas (Philadelphia, PA)
- …the case is presented to the Medical Director for medical necessity review . Upon approval of services, responsibilities include timely notification and education to ... longer needed or until the member's 21st birthday. ;The nurse will maintain current knowledge and understanding of the...Experience:** + **Qualified candidates will be able to work Monday through Friday between 8:30a EST and 5:00p EST.**… more
- Aspen Medical (Aurora, CO)
- …and Management (HCQM) through American Board of Quality Assurance and Utilization Review Physicians (ABQARP), Certified Informatics Nursing, Ambulatory Care ... JOB AD: Registered Nurse - Utilization Management Introduction : Aspen Medical...in a direct patient care clinical setting. Must have utilization management, utilization review or… more
- CVS Health (Austin, TX)
- …operation. Work schedules may include weekends and holidays and evening rotations._ As a Utilization Management Nurse Consultant you will be responsible for the ... Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN...Monday through Friday 8:00am to 5pm CST + Utilization management is a 24/7 operation. Work schedules will… more