Utilization Review Nurse Jobs in USA

General Summary:Responsible for supporting the utilization review system including data analysis report writing and program improvement.UR Specialist will develop and maintain a VOD Tracking and Receipt system.UR Specialist will maintain an expert level review of client entitlements and billing auth...

Job Title: Registered Nurse (RN) Case Manager / Utilization Review / CDILocation: Syracuse NY Duration: 13 WeeksJob SummaryWe are seeking an experienced Registered Nurse Case Manager with a strong background in Utilization Review and Clinical Documentation Improvement (CDI). The RN will be responsi...

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy should you join...

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy should you join...

DescriptionPRN Position for Inpatient and Outpatient (PHP/IOP) Utilization.Your experience mattersMesa Springs is part ofLifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide...

The RN Utilization Specialist reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.The RN Utilization Specialist (RN...

Job Title: Registered Nurse - Utilization Review Location (On-site Remote or Hybrid): Everett WA (onsite) Contract Duration: 13 weeks Working hours:Day 5x8-Hour (08:00 - 16:30) Total hours: 40 Start date: ASAP Shift:5x8 Days Monday-Friday Years of Experience Required: 1 year First-timers a...

Primary Location: Peace - LouisvilleAddress: 2020 Newburg Rd. Louisville KY 40205 Shift: Varied (United States of America)Job Description Summary: UofL Health is a fully integrated regional academic health system with five hospitals four medical centers nearly 200 physician practice location...

This is a casual (non benefited) position supporting our Case Management UR department at Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital. This role would be working remotely and would require some weekend coverage. **The Case Manager RN UR/Bed Planner Part Time reflects the missi...

Sign on bonus may apply up to $15000 Position Summary: Reviews patient admissions for appropriateness efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts determining whether care provided is within established parameters....

DescriptionYour experience mattersCopper Springs is part of Lifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialis...

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your care...

Fusion HCR is hiring! Direct Hire Utilization Review Nurse this is an onsite position working with our client in Acute Care. OverviewSeeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity appropriate level of care and compliance with payer guidelines...

Primary Responsibilities include but are not limited to:1. Acts as the responsibility centers point of contact for the Corrective Action Program (CAP) issues and implementation. This includes:Maintains a thorough working knowledge of the CAP process.Monitor the timely processing of condition reports...