• Utilization Review Nurse (On-…

    Beth Israel Lahey Health (Burlington, MA)
    …Rotation **Job Description:** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...collaboratively with RN Case Managers to expedite patient discharge On- site in Burlington. + Maintains current knowledge of hospital… more
    Beth Israel Lahey Health (04/18/25)
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  • Utilization Review Nurse (On-…

    Beth Israel Lahey Health (Burlington, MA)
    …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse (RN), Massachusetts + Three years of recent clinical… more
    Beth Israel Lahey Health (02/14/25)
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  • Utilization Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... **Details** + **Department:** Utilization Management + **Schedule:** On- site , Monday-Friday,...review programs and key performance indicators for all utilization review activities. + Interact with medical,… more
    Ascension Health (03/26/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
    Beth Israel Lahey Health (04/16/25)
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  • RN - Utilization Review

    Providence (Centralia, WA)
    **Description** The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization ... Nursing **Preferred Qualifications:** + Bachelor's Degree Nursing Or + 3 years Utilization Review , Care Management, Quality Management, and/or Discharge planning… more
    Providence (04/01/25)
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  • Manager - Utilization Review

    Ochsner Health (Lafayette, LA)
    …or other related MCO departments/functions. **Certifications** Required - Current registered nurse (RN) license in state of practice. *MSW accepted in lieu ... of registered nurse (RN) licensure. Preferred - Certification in Case Management...Determines appropriate staffing levels and the interviewing, hiring, performance review , and termination of employees within practice unit(s); maintains… more
    Ochsner Health (04/04/25)
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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 team, ... responsible for preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures the appropriate level of… more
    Ellis Medicine (04/03/25)
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  • Care Review Clinician, Prior Authorization…

    Molina Healthcare (Seattle, WA)
    …in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... appropriate and cost-effective based on the severity of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** + Assesses services for members to ensure… more
    Molina Healthcare (04/11/25)
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  • RN Utilization Manager

    Ochsner Health (New Orleans, LA)
    …efficiently in high pressure situations. Preferred- Experience in Case Management or Utilization Review Business and Financial Knowledge as well as understanding ... discover your future today!** This job is a registered Nurse with a diverse medical background, who is able...physician and applies hospital approved medical necessity criteria to review appropriate admissions, levels of care and continued stay.… more
    Ochsner Health (04/11/25)
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  • Community Care Nurse (RN)

    ChenMed (Philadelphia, PA)
    …engagement with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ; provides family ... people to join our team. The Community Care RN ( Nurse Case Manager) is responsible for achieving positive patient...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
    ChenMed (03/08/25)
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