- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... H&Ps and admitting orders of all direct, transfer, and emergency care patients designated for admission to ensure compliance...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II...to its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 ... Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -...emergency response system, as well as Housing for Health… more
- McLaren Health Care (Pontiac, MI)
- …Responsible for Utilization and Care Management services to the Emergency Center. Advises providers to determine initial medical necessity and transition ... on all patients reviewed in the ED. Conducts initial review using InterQual, MCG and other tools, assists provider...assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited… more
- AmeriHealth Caritas (Washington, DC)
- …efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, ... Bachelor's Degree in Nursing (BSN) preferred. + A Registered Nurse (RN) license in the District of Columbia in...ability to meet productivity standards in a fast-paced, high-volume utilization review environment. + Availability to work… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with physicians, residents, ... officers, Emergency Department (ED) staff, and Bed Management. The nurse is responsible for applying clinical skills in reviewing, assessing and evaluating… 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
- Veterans Affairs, Veterans Health Administration (Gainesville, FL)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for UM reviews for patients who receive hospital care. Responsibilities An UM ... Registered Nurse is responsible for UM reviews and use of...including practice guidelines, accreditation standards, and performance measures. Uses emergency and bed management software and utilization … more
- Alameda Health System (Oakland, CA)
- System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Evening + ... + Req #:41910-31048 + FTE:1 + Posted:May 22, 2025 **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/210205/registered- nurse -case-manager utilization ... Weslaco, Texas. With 227 beds, the community hospital specializes in emergency care, orthopedics, obstetrics and gynecology, wound care, surgery, cardiology,… more
- Trinity Health (Columbus, OH)
- …technology, financial analysis, audit, provider relations and more. **Position Purpose** RN Utilization Review MCHP is responsible for the coordination of the ... Sr. Director of Medical Management. + Coordinates with the utilization review , case management, discharge planning staff.../ Certification: Current license to practice as a Registered Nurse in their home state or hold a compact… more