• Utilization Reviewer ( RN

    Atlantic Health System (Morristown, NJ)
    …Assists in identification and collection of avoidable days 7. Coordinates with the CM RN and/or CMA to identify and complete the process for CMS required patient ... notices. 8. Completes and documents utilization reviews, physician advisor referrals and other communications related to assigned cases in accordance with department… more
    Atlantic Health System (04/24/25)
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  • RN Utilization Review

    HonorHealth (Scottsdale, AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... 1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required more
    HonorHealth (03/12/25)
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  • Utilization Management Specialist…

    Trinity Health (Stafford Springs, CT)
    …Day Shift **Description:** RN or Social Worker **Position Purpose** The Utilization Management Specialist is responsible for acute care concurrent review ... of illness (profiling) by working with the physician in the concurrent review process. May assist with patient care services care coordination, psychosocial groups… more
    Trinity Health (04/30/25)
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  • Utilization Management RN

    Ellis Medicine (Schenectady, NY)
    Basic Function: The Utilization Management Registered Nurse (UM RN ) supports daily coordination of care across healthcare continuum with the healthcare ... preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures...care related field required. Current registration as a Licensed Registered Professional Nurse in New York State.… more
    Ellis Medicine (04/03/25)
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  • Utilization Review Specialist | 40…

    Great River Health (West Burlington, IA)
    …browser Qualifications + 4-6 years clinical experience Required + Previous experience in Utilization Review Preferred + Knowledge of the structure and content of ... maintaining compliance with the CMS Conditions of Participation for Utilization Management.What you will do + Review ...identify and understand the speech of another person. + Registered Nurse Iowa Board of Nursing (IBON)… more
    Great River Health (04/05/25)
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  • Utilization Review RN Point…

    Trinity Health (Des Moines, IA)
    …Iowa (IA), MercyOne Des Moines Join the MercyOne Family! We are looking to hire a Utilization Review RN ! Responsible for the review of inpatient and ... the STAR admitting system. ESSENTIAL FUNCTIONS: + Conducts admission review per the Utilization Management...SKILLS AND ABILITIES REQUIRED:** + Current licensure as a registered nurse in the State of Iowa.… more
    Trinity Health (04/19/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Services As Needed / ... **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (04/26/25)
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  • RN Utilization Review

    Guthrie (Binghamton, NY)
    …health care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service requests ... with healthcare team members. May prepare statistical analysis and utilization review reports as necessary. Oversees and...pay range for this position is $31.00 - $45.26 per hour. #LI-RB1 Joining the Guthrie team allows you… more
    Guthrie (04/05/25)
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  • Utilization Management Reviewer

    Excellus BlueCross BlueShield (Rochester, NY)
    …This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ... entities. Refers appropriate cases to the Medical Director for review . Refer to and work closely with Case Management...on-call schedule, as required, to meet departmental time frames. Per department needs, may be responsible for additional hours.… more
    Excellus BlueCross BlueShield (03/29/25)
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  • Utilization Management Nurse - 3…

    Omaha Children's Hospital (Omaha, NE)
    … management. + Should be a creative, flexible, risk taker. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... including veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing...Licensure Required and + RN -BC - Case Management Nurse Preferred Children's… more
    Omaha Children's Hospital (03/21/25)
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