Adheres to CMS guidelines for utilization reviews as evidenced by utilization of the relevant guidelines and appropriate referrals to the physician advisor and the UR Committee. Gathers clinical infor...

The Department of Care Management at SUNY Downstate Health Sciences University is seeking a full-time Utilization Review Nurse / TH Utilization Review/Quality Assurance Senior Coordinator (Nights). Ut...

Review assessment findings with the PCP to identify any concerns that have not been identified by the clinical team. Review and evaluate the assessment and UAS information for members in the MLTC and ...

Utilization Management / Appeals RN. They will be reviewing documentation, codes, and more for out of Network bills and cost and making determinations on how to move forward based on the evidence.

Minimum of two (2) years utilization review/case management experience or social work experience. Commission for Case Management Certification (CCMC) or Association of Rehabilitation Nurses). Successf...

Utilization Management / Appeals RN. They will be reviewing documentation, codes, and more for out of Network bills and cost and making determinations on how to move forward based on the evidence.

Complete initial admission reviews within 24 hours of admission, including reviews for those that were admitted during hours without an access nurse on duty. Complete daily utilization review of all o...

Complete initial admission reviews within 24 hours of admission, including reviews for those that were admitted during hours without an access nurse on duty. The RN - Utilization Management gathers cl...

Are you ready to choose your next adventure in care? We’re seeking a hardworking, hard-playing RN (Registered Nurse) to fill a Case Management (Utilization Review) opening in Bronx, NY. Nurses ...

The Department of Care Management at SUNY Downstate Health Sciences University is seeking a full-time Utilization Review Nurse / TH Utilization Review/Quality Assurance Senior Coordinator (Nights). Ut...

The Department of Care Management at SUNY Downstate Health Sciences University is seeking a full-time Utilization Review Nurse / TH Utilization Review/Quality Assurance Senior Coordinator. Th Utilizat...

Do you thrive in a dynamic, fast-paced environment and enjoy the flexibility of travel nursing? If so, we have an exciting opportunity for you! We are seeking a dedicated Travel RN specializing in Uti...

Do you thrive in a dynamic, fast-paced environment and enjoy the flexibility of travel nursing? If so, we have an exciting opportunity for you! We are seeking a dedicated Travel RN specializing in Uti...

Do you thrive in a dynamic, fast-paced environment and enjoy the flexibility of travel nursing? If so, we have an exciting opportunity for you! We are seeking a dedicated Travel RN specializing in Uti...

Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in White Plains, New York. Posted job title: Case Management (Utilization Review). What do we d...

The Utilization Review Nurse Per Diem will:. Utilization Review Nurse Per Diem. Utilizes case management software including utilization criteria guidelines, to capture essential admission clinical rev...

Utilization Review Nurse/Care Manager within a Healthcare system in NJ. We are looking for RN's that have strong inpatient clinical background or experience in Care Management/Utilization Review. The ...

ASAP, looking to get all RNs started together. Utilization management experience.

The Utilization Review Nurse promotes effective utilization and monitoring of health care resources to achieve desired clinical, financial and resource outcomes. We have an exciting opportunity for a ...