Now hiring for a Top Healthcare / Managed Care company in McAllen, TX whom are in need of an experienced Care Manager RN to become a part of the team, for an onsite position. Please apply directly ...

Requires a graduate from an accredited school of nursing and holding current state Registered Nurse (RN) license. Compact state licensure is preferred. Additional state licensure to meet contractua...

As a Utilization Review Nurse, you will be responsible for assessing, planning, implementing and coordinating all case management activities as well as evaluating the medical needs of the member to...

Complies with all standard operating procedures, and all departmental and organizational policies. Meets and exceeds minimum benchmark established for the role. Develops relationships with physicia...

The Nurse Manager Case Management will be a key member of the leadership team, and will report directly to the Director of Case Management The Utilization Review Nurse Manager will be responsible a...

The Discharge Planner/Utilization Review RN conducts admission, concurrent with retrospective utilization reviews for all assigned patients. This individual communicates with payers, physicians and...

Clinical Review Nurse needed for a contract opportunity with Yoh’s client located in Alameda, CA! Top Skills Should You Possess: Previous experience Appeals & Grievances What You’ll Be Doing: C...

Reporting to the Nurse Manager of Case Management, the Case Manager Utilization Review will collaborate with physicians, nursing staff, and hospital leadership to develop interdisciplinary plans fo...

Are you ready for an exciting new opportunity with a Fortune 50 healthcare plan? Healthcare Support is currently accepting applications to join a value-driven managed care organization for a Remote...

Now hiring for a Top Healthcare company located near the Waukegan, IL whom are in need of an experienced Medical Review Nurse - Adverse Events to become a part of the team, for an onsite position.T...

The Emergency Department Case Manager / Utilization Review Nurse collaborates with all members of the Emergency Department/Clinical Resource Management (CRM) team to review and coordinate the admis...

A fantastic career opportunity for Nurse Case Manager is now available with a reputable non profit community hospital in beautiful, sunny and coastal San Francisco Bay Area of California. If you en...

The Nurse Supervisor Utilization Review RN will be responsible for implementing and developing all case management functions. The Nurse Supervisor will act as a liaison between healthcare professio...

Registered Nurse uses approved screening criteria (Milliman/Interqual/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for tha...

Responsible for utilization review and interdisciplinary coordination with a variety of providers, the most cost effective, quality care for managed health care enrollees in different lines of busi...

We are hiring a Utilization Review Registered Nurse for our Fortune 500 healthcare client in Las Vegas, NV. Pay : $33.00-$43.00/Hr Schedule: Monday-Friday 8am- 5pm. Status: Full Time Location: Las ...

Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine the medical necessity of a requested hospitalization and the appropriate level of care for that patient. Act...

Responsible for utilization review and interdisciplinary coordination with a variety of providers, the most cost effective, quality care for managed health care enrollees in different lines of busi...

Tower Health is a strong, regional, integrated healthcare provider/payer system that offers leading-edge, compassionate healthcare and wellness services to a population of 2.5 million people. Toget...

A top medical center in beautiful Massachusetts is now hiring for an to join their Case Management RN Care Management and Utilization Review leadership team. Reporting to the RN Director of Case Ma...

· The two major functions of the Post-Acute Care Case Manager (PACCM) are to ensure the customer is at the appropriate level of care, and to initiate and follow through in the discharge planning pr...

The Inpatient Care Management Manager RN will oversee all operations within Health Care Services which included: intake, review functions, authorizations, concurrent review (CCR), Claims, Review an...

Drafts corrective action plan (CAP) requests and educational letters for Medical Director to be sent to providers based on quality findings. Presents CAP responses to Medical Director and/or PRC. C...

Description: The Judge Group is currently seeking a Utilization Review Registered Nurse in the Berwyn, PA area. This position will be in support of a dedicated healthcare professional staff with on...

This established 100-year old healthcare system has grown into a technologically advanced medical center that now houses nearly 300-beds and offers roughly 50 specialty clinical services. This faci...