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Sep 18 Utilization Review Nurse Myriddian Columbia, MD

appropriateness, necessity of the use of medical services, procedures, and facilities. ... This position is empowered to review medical services with evidenced-based... more

Sep 18 Registered Nurse (Utilization Review) U.S. Department of Veterans Affairs Tampa, FL

care in a cost-effective manner. The NON-VA Medical Care Coordinator (NVCC Nurse) ... federal regulations, VHA guidelines, medical review criteria, utilization management... more

Sep 17 Utilization Review Nurse Lead Workstaff USA Staffing Agency Pullman, WA

of Case Management, the Utilization Review Nurse Lead oversees the practices of ... and discharge criteria have been met. Review medical records as necessary to assure... more

Sep 17 Medical Review Nurse–Licensed Vocational Nurse (LVN)/Registered Nurse (RN) Healthcare Scouts New Braunfels, TX

Medical Review Nurse – Licensed Vocational Nurse (LVN)/Registered Nurse (RN) role gives ... The ideal Medical Review Nurse – Licensed Vocational Nurse (LVN)/Registered Nurse (RN) can... more

Sep 17 Utilization Review Nurse RN Novant Health Charlotte, NC

The Utilization Review RN serves as a leader resource in the Utilization Review process ... medical necessity reviews. All Utilization Review activities are performed in accordance... more

Sep 13 In-House Medical Reviewer Record Expess Milford, OH

reviewing medical records to create detailed medical chronologies. Experience in ... skills are required. Medical record review and chronology creation training will... more

Sep 12 Registered Nurse- (Utilization Review) U.S. Department of Veterans Affairs White River Junction, VT

(UM) Nurse is a registered professional nurse, qualified by education and experience. ... approved standardized evidence-based UM review criteria are used. * Ensuring review... more

Sep 12 Medical Reviewer LPN Blue Cross Blue Shield of Texas Fort Worth, TX

with the medical contract and regulations, medical criteria, utilization review, and ... with PC or database systems. *Utilization review or utilization management... more

Sep 12 Medical Review Coordinator I Advanced Medical Reviews Los Angeles, CA

Company Description: Advanced Medical Reviews, Inc (AMR) is an Independent Review ... - To learn more about independent medical reviews please visit: CA Medical reviews http://... more

Sep 12 Medical Review RN - Per-Diem Mercy Healthcare Sacramento Sacramento, CA

Health designated criteria for primary review. Incorporates into the utilization review ... Health. Accountabilities: 1. Completes medical necessity utilization reviews and... more

Sep 10 Registered Nurse / Travel / Medical Reviewer Mas Medical Staffing Brattleboro, VT

Registered Nurse / Travel / Medical Reviewer MAS Medical Staffing has an immediate need for a licensed Registered Nurse for a travel (temporary) assignment. Please have at least 2... more

Sep 10 Clinical Care Reviewer UM, RN AmeriHealth Charleston, SC

to perform a thorough medical necessity review. It is within the nurse’s discretion ... cases as needed. The nurse will apply medical health benefit policy and medical... more

Sep 09 Medical Reviewer RN Blue Cross Blue Shield of Texas Fort Worth, TX

for ensuring accurate and timely medical review of professional provider claims ... interpretations.JOB REQUIREMENTS:*Registered Nurse with current, active, unrestricted... more

Sep 04 RN Medical Case Manager/Utilization Review Nurse - Workers Compensation Travelers Buffalo, NY

and medical treatment as well as in-house medical reviews as applicable to claim ... Peer Review vendors, Major Case, etc.)Obtain medical records from providers telephonically... more

Aug 27 Utilization Review Nurse Newport Academy Bethlehem, CT

retrospective and concurrent Utilization Review, Discharge Planner and Crisis ... relating to UR/UM Discharge activities; review policies and procedures periodically... more

Aug 25 Medical Bill Review- Registered Nurse (RN) Healthcare Scouts Fort Worth, TX

for the Medical Bill Review-Registered Nurse (RN) will be expediting and ... Balance Required Skills:The Medical Bill Review-Registered Nurse (RN) will bring an... more

Aug 18 TriStar Centennial Medical Center - Registered Nurse (RN) - Utilization Review - PRN Usr Healthcare Nashville, TN

Medical Center - Nashville, TN Registered Nurse (RN) - Utilization Review - PRN Our 657 ... Responsibilities: * The Utilization Review Nurse performs medical necessity reviews on... more

Aug 12 Retro reviewCase Manager- LVN- Utilization Review - Varied Shifts( Full Time)posted 5/7/14 Tenet Healthcare Fountain Valley, CA

The LVN/LPN Case Manager is responsible to conduct medical necessity screening and work co ... Department orientation includes review and instruction regarding Tenet Case... more

Aug 12 Retro Review Case Manager- LVN- Utilization Review - Varied Shifts( Per Diem)posted 5/7/14 Tenet Healthcare Fountain Valley, CA

physician. If no determination, the UR nurse will refer the case to the Medical ... daily per P&P #8756-M 8.0 * Prepares review sheets for all patients, Medi-cal,... more

Jul 28 Clinical Care Reviewer, RN - Per Diem AmeriHealth Philadelphia, PA

Management, the Clinical Care Review Nurse is responsible for completing medical ... Medical Director for medical necessity review when medical information provided does not... more

Jul 25 Clinical Care Reviewer, RN - Per Diem Nurse AmeriHealth Philadelphia, PA

Management, the Clinical Care Review Nurse is responsible for completing medical ... Medical Director for medical necessity review when medical information provided does not... more

Jul 17 MANAGER,CLINICAL RESOURCE CENTER (Utilization Review/Pre-Cert) RN BSN Temple University Health System Philadelphia, PA

- PA Registered Nurse License (Required) CCM - Certified Case ... challenge you to be your best, our academic medical center is second to none. Here, in... more

Jun 18 RN-Registered Nurse-Manager Code Edit & Med Nec Review-Managed Care Nurse Resolutions Spokane, WA

process thru claim review, medical record review and research. Responsible to review ... deliverables of all Coding/Billing Edits and Medical necessity claim... more

May 09 Utilization Review Nurse Novant Health Salisbury, NC

medical necessity reviews. All Utilization Review activities are performed in accordance ... Utilization Review or related experience preferred. * Licensure/certification/registration... more

Feb 23 Utilizat Review LPN Novant Health Charlotte, NC

care, level of care, and quality of care medical reviews for hospitalized patients. ... initial, concurrent, and retrospective medical record reviews. Makes utilization... more

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