- Actalent (San Antonio, TX)
- Job Title: Review Nurse Job Description The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical necessity for ... successful completion of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case… more
- Centene Corporation (Salem, OR)
- …needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member ... approve medical determinations or provide recommendations based on requested services and concurrent review findings + Assists with providing education to… more
- Trinity Health (Troy, NY)
- …administrative requirements for Utilization Management and works collaboratively with Utilization Management/ Concurrent Review Nurse , physicians, staff and ... possible concurrent denials, forwards information to the appropriate Utilization Management/ Concurrent Review Nurse within identified process standards *… more
- RWJBarnabas Health (Jersey City, NJ)
- Nurse Midwife-PD Days-MMG Concurrent -Jersey City-NJReq #:0000192616 Category: Nurse Midwife Status:Per Diem Shift:Day Facility:Jersey City Medical Center ... Department:MMG Concurrent Location: Jersey City Medical Center, 355 Grand Street,...Street, Jersey CIty, NJ 07302 Job Summary: The Certified Nurse Midwife position provides antepartum, intrapartum, postpartum, neonatal and… more
- Beth Israel Lahey Health (Burlington, MA)
- …being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for ... people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status based on… more
- UPMC (Hanover, PA)
- **UPMC is hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part time, day shift position with a rotating ... measures information for JCAHO requirements. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor, Attending… more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews, post-acute care… more
- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... provider-to-patient ratios and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team of talented professionals… more
- HCA Healthcare (Nashville, TN)
- …**Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current employer? We have an exciting ... of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for creating positive patient interactions is valued? If… more
- Dignity Health (Gilbert, AZ)
- …the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more