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CAREERBUILDER APPLY
2w
2 weeks ago

Full-Time

Utilization Review (UR) Case Manager A local Hospital in the Glendale area is seeking a Utilization Review Nurse. Utilization Review including assessment of medical records for appropriateness, level of care provided. Assess utilization of treatment, moda

Glendale

Full-Time

New Century Health is leading transformative change in specialty care management. By combining medical management expertise with a deep understanding of healthcare informatics, physician management and healthcare technology systems development, we generat

Brea

CAREERBUILDER APPLY

Full-Time

Position Overview Utilize your clinical experience and launch your career in a new and exciting direction as a Clinical Quality Review Nurse with a Monday – Friday schedule (no evenings, no weekends, no on call) in an office setting. The Clinical Quality

Fort Worth

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CAREERBUILDER APPLY

Full-Time

Environmental Conditions The majority of duties are performed in a controlled office environment; desk work may involve extended periods of sitting, phone time, typing on PC keyboard. Performs utilization review of labor and delivery admissions, outpatien

19 South La Salle Street
Chicago

CAREERBUILDER APPLY
4w
4 weeks ago

Full-Time

Position Overview POSITION OVERVIEW: HealthCare Scouts, Inc. is actively interviewing for a Clinical Review Nurse (RN) for an industry leading, NCQA accredited health plan, with a commitment to continuous quality improvement initiatives and exceeding memb

New Albany

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4d
4 days ago

Full-Time

The Clinical Review Nurse is responsible for reviewing and making medical determinations as the validity of health claims and levels of payment in meeting national and local policies as well as accepted medical standards of care. The incumbent applies cli

Florida Blue

Mechanicsburg

CAREERBUILDER APPLY
1w
1 week ago

Full-Time

GENERAL SUMMARY: This position is responsible for coordination of all aspects of the patient’s care and services in a health care facility. Intervention is during hospitalizations and SNF stays. This will include concurrent, retrospective and medical clai

Care1st Health Plan Arizona, Inc.

2355 East Camelback Road
Phoenix

1w
1 week ago

Full-Time

Utilization Review / Case Manager Nurse RN Kelly Services has an exciting opportunity for a Utilization Review / Case Manager RN Nurse to work in Atlanta, GA. This is an exciting opportunity to work for a very large insurance company If you’re ready to he

Atlanta

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3d
3 days ago

Full-Time

HEDIS REVIEW NURSE - RN Join Kelly Healthcare Resources and our team of compassionate, “put people first” individuals to fulfill immediate openings for a HEDIS REVIEW NURSE in CHICAGO, IL today! As the HEDIS Review Nurse with a global health insurance ser

Chicago

CAREERBUILDER APPLY
2w
2 weeks ago

Full-Time

Position Overview Are you looking for a new opportunity in a challenging but rewarding environment? Are you looking to expand your career within Managed Care? As a Utilization Review Nurse, you will promote the quality and cost effectiveness of medical ca

Lenexa

CAREERBUILDER APPLY

Full-Time

Medical Record Review Nurse - Travel The Medical Record Review Nurse is responsible for the completion of target chart reviews and addendums. Responsibilities: Medical Record Review Nurse will assist in the development of clinical analytic rules and integ

DxID

East Rochester

4d
4 days ago

Full-Time

The Concurrent Review Nurse is responsible for the management of inpatient and observation services provided to members with a focus on discharge planning in order to decrease/prevent unplanned transitions. ESSENTIAL DUTIES AND RESPONSIBILITIES: Evaluates

Tampa

CAREERBUILDER APPLY

Full-Time | Pay: $60k - $70k/year

RN, Utilization Review Nurse A-Line Staffing is currently looking for a Registered Nurse for Utilization Review in both the Buffalo and Rochester New York areas. This company is looking to set up interviews immediately as this position will fill up very q

Buffalo

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1w
1 week ago

Full-Time

Job Description SCOPE: Under general supervision, this position is responsible for the initial chart review on a medical exam/screening program. Works directly with physicians and candidates to ensure all medical information is gathered for a final medica

Reston

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CAREERBUILDER APPLY

Full-Time

The Professional Review Nurse provides analysis of medicalservices to determine appropriateness of charges on multiple types of medicalbills and review of medical reports to determine appropriateness of medicalcare. Clinical and/or technical expertise

CorVel Corporation

N16W23217 Stone Ridge Drive
Waukesha

6d
6 days ago

Full-Time

The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in meeting national and local policies as well as accepted medial standards of care. The incumbent applies c

Florida Blue

Mechanicsburg

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1w
1 week ago

Full-Time | Pay: $32.40 - $33.00/hour

The two major functions of the Post Acute Care CaseManager are to ensure the customer is at the appropriate level of care, andtoinitiate and follow through in the discharge planning process. Given thecomplex nature and challenges of the US health system a

Atlanta

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3w
3 weeks ago

Full-Time

Universal Health Services, Inc. (UHS) knows what it takes to lead, inspire and succeed. One of the nation’s largest and most respected hospital companies, UHS owns and operates through its subsidiaries acute care hospitals, behavioral health facilities an

KING OF PRUSSIA

CAREERBUILDER APPLY
6d
6 days ago

Full-Time | Pay: $32.00/hour

Intro: Are you an experienced Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions

Bloomington

6d
6 days ago

Full-Time

The U.R. Nurse gathers demographic and clinical information on prospective, concurrent, and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay. ESSENTIAL JOB DUTIES The

Cincinnati

CAREERBUILDER APPLY

Seasonal/Temp

An RN with Medical Records Review experience is needed to conduct quality reviews of patient services provided in the community. If you have at least two years of experience participating in quality improvement initiatives and conducting clinical quality

Washington

CAREERBUILDER APPLY

Part-Time

REGISTERED NURSE / UTILIZATION REVIEW / MANAGED CARE A-Line Staffing Solutions is seeking 4 experienced Registered Nurses to work a telephonic, PART-TIME opportunity for a Fortune 500 managed care group based in Maitland, Florida. We’re looking to fill 2

Maitland

6d
6 days ago

Full-Time

Utilization Review Nurse job in Indianapolis, IN We are currently recruiting for an experienced Utilization Review Nurse. This position does require a degree in Nursing Case Management or a Utilization Review Certification. In this role you will be workin

Indianapolis

View 1 more

CAREERBUILDER APPLY
1w
1 week ago

Full-Time

This position will NOT be treating patients or distributing medication. The Registered Nurse will perform clinical and operational processes related to transition / coordination of care and utilization / case management of Post Acute Care services includi

Franklin

CAREERBUILDER APPLY

Full-Time | Pay: $20.00 - $33.00/hour

Medix is hiring an LVN or RN Utilization Review Nurse immediately for a Hospital partner in the West Houston area. This position will be onsite with their Health Plan in their growing Medicare department. This opportunity will not be available long so if

4550 Post Oak Place Drive
Houston

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