- Community Health Systems (Naples, FL)
- …Onsite Role ** Comprehensive Benefits **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, ... development of policies and procedures, standard work and educational materials for the UR department. Will be a partner with other staff members, providers, and… more
- UTMB Health (Friendswood, TX)
- …optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical knowledge, ... Program Mgr UR /Case Management - CMC - Clear Lake Center...FUNCTIONS_** **:** + Supervises the operational management of the Utilization Review /Case Management program to ensure high… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: The Utilization Review /Quality Assurance Sr. Coordinator will be responsible for providing clinical information to managed care companies as ... agencies, and other health care related entities. Preferred Qualifications: Utilization Review /Managed Care/Quality Assurance experience. Experience in the… more
- Trinity Health (Maywood, IL)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal ... campus. Position is hybrid, local candidates preferred. The **Regional Utilization Review Documentation Specialist** nurse works with...coverage. The position includes but not limited to basic UR job duties such as level of care determination,… more
- University of Utah Health (South Salt Lake, UT)
- …and as a team member. **Qualifications** **Qualifications** **Required** + One year Utilization Review or Case Management experience. **Licenses Required** + ... to identify at risk patients. + Refers to UR committee any case that surpasses expected LOS, expected...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review ( UR ) Nurse is responsible for the clinical review ... appropriate exceptions, coordinating with Medical Directors on denials. In addition, the UR nurse is responsible for completing inpatient level of care reviews,… more
- Ochsner Health (New Orleans, LA)
- …management, interpersonal and conflict resolution skills. **Job Duties** + Lead and directs Utilization Review ( UR ) staff and functions, including staffing, ... reviews to identify escalation issues regarding Providers, other facility issues, individual utilization review staff skills, payor-based concerns and to provide… more
- The Arora Group (Bethesda, MD)
- …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse (RN) and pre-certification clerk. + ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a...The Contractor performing as the License Practical Nurse (LPN) Utilization Reviewer ( UR ) shall make coverage decisions… more
- HonorHealth (Scottsdale, AZ)
- …communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... Required 1 year experience in UR /UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact State Licensure Required more
- Providence (Olympia, WA)
- **Description** The Utilization Review ( UR ) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... people, we must empower them. **Required Qualifications:** + Washington Registered Nurse License upon hire. + 3 years -...+ Associate's Degree - Nursing. + 3 years - Utilization Review , Care Management, Quality Management, and/or… more