• NCCPAC Revenue Utilization Review

    Veterans Affairs, Veterans Health Administration (Middleton, WI)
    Summary The Revenue Utilization Review (RUR) nurse ...level degree in Nursing may have opportunity to become registered as a nurse with a state ... the Nurse Manager and ANM. The RUR nurse is an active member of the revenue cycle...improvements in patient care through systematic evaluation and analytical review of clinical information. Responsibilities Responsibilities of the RUR… more
    Veterans Affairs, Veterans Health Administration (11/25/25)
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  • Utilization Review Analyst…

    Beth Israel Lahey Health (Burlington, MA)
    …the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized ... the medical necessity of the hospital care. Using the concepts of utilization review , clinical documentation improvement and revenue integrity, these specialized… more
    Beth Israel Lahey Health (10/30/25)
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  • Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)*… more
    Minnesota Visiting Nurse Agency (11/04/25)
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  • Utilization Review

    Actalent (Atlanta, GA)
    Utilization Review ( Registered Nurse ) Job Description This role involves performing precertification and medical necessity reviews for designated ... Benefits - Appeals, and Risk Management. Essential Skills + Registered Nurse (RN) with a valid license...+ Experience with MCG or Interqual is preferred. + Utilization review experience is a plus. Job… more
    Actalent (11/24/25)
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  • Utilization Review Nurse

    Emory Healthcare/Emory University (Decatur, GA)
    …_,_ and leadership programs + And more **Description** We're seeking a **Clinical Utilization Review Nurse Preceptor ( Registered Nurse / RN)** . This ... individual will be responsible for training, mentoring, and coaching for the Utilization Review Department and must be an expert in the utilization review more
    Emory Healthcare/Emory University (11/27/25)
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  • Nurse

    Veterans Affairs, Veterans Health Administration (Leavenworth, KS)
    …and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the supervision of a ... Summary The Revenue Utilization Review (RUR) nurse ...clinical registered nursing experience, experience with authorizations, utilization review , or insurance authorization experience; critical… more
    Veterans Affairs, Veterans Health Administration (11/28/25)
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  • Registered Nurse (RN) Case Manager…

    Ochsner Health (New Orleans, LA)
    …case management or utilization review . **Certifications** Required - Current registered nurse license in state of practice. Basic Life Support (BLS) from ... and implement discharge plans based on patient's individualized needs. Registered Nurse (RN) Case Manager - Case...of the conditions of participation as it relates to utilization review and discharge planning. + Maintains… more
    Ochsner Health (10/29/25)
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  • Nurse Case Manager: Full Time, DAYS

    Albany Medical Center (Albany, NY)
    …with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire - required ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to achieve… more
    Albany Medical Center (11/25/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About ... + 3+ years of experience as an RN + Registered Nurse in state of residence +...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
    US Tech Solutions (10/17/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Lafayette, LA)
    …ability to meet productivity standards in a fast-paced, high-volume utilization review environment. **Licensure:** + An active Registered Nurse (RN) ... care organization. + Proficiency in Electronic Medical Record Systems and Utilization Review Systems (eg, JIVA) to efficiently document and assess patient cases.… more
    AmeriHealth Caritas (11/04/25)
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