Posted Job Title Company Location

Looking to hire? Post your job today!

Featured Job Postings from the Web
Oct 21 Utilization Review Nurse RN Novant Health Winston-Salem, 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

Oct 20 Medical Reviewer LPN - Utilization Management Blue Cross Blue Shield of New Mexico Albuquerque, NM

with the medical contract and regulations, medical criteria, utilization review, and ... PREFERRED JOB REQUIREMENTS: *Utilization review or utilization management experience. more

Oct 20 Utilization Review Nurse, Long Island Tenet Healthcare Brooklyn, NY

integrated, URAC certified web-based medical management software application that ... tool that support all levels of medical management interventions; utilization... more

Oct 17 Continuing Care / Utiization Review Coordinator RN(289273) Kaiser Permanente Manteca, CA

Essential Functions: • Conducts utilization review for in-house patients and/or members wh ... of review preferred. Primary Location : California-Manteca-Manteca Yosemite Medical... more

Oct 16 RN / Registered Nurse / Medical Review / Appeals A-line Staffing Solutions Southfield, MI

is seeking experienced RN/ Registered Nurse / Medical Review / Appeals professional ... review, HEDIS, appeals, denials, medical chart review, review analyst, quality... more

Oct 16 Medicare Medical Review RN - Casual Employment/Flex Schedule NCI Information Systems Nashville, TN

Medicare Medical Review RN - Casual Status ( Medical Reviewer III ), your experience in ... 4 years experience reviewing medical claims to determine medical necessity and... more

Oct 15 MEDICAL REVIEW RN 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

Oct 14 Healthcare Physician Practice Consultant / Medical File Review Nurse UnitedHealth Group New York City, NY

Requirements Requirements: - Medical/clinical background desirable (NP) - 7+ years ... nurse, nurse practitioner, RPN, Medical File Review, Medical Coding Careers with... more

Oct 13 Sr. Medical Review- Utilization Review Nurse Federal Staffing Resources (fsr) Glen Burnie, MD

Staffing Resources is seeking a Sr. Medical Review- Utilization Review Nurse to provide ... Medical Directors for decision. The Medical Review URN is available as a reference source... more

Oct 11 Medical Reviewer LPN - Utilization Management Blue Cross Blue Shield New Mexico Albuquerque, NM

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

Oct 10 Utilization Review Nurse 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

Oct 03 Medical Necessity Reviewer(286832) Kaiser Permanente Portland, OR

financial liability for out-of plan medical services. Performs special projects, ... work experience in Medical Necessity Review. • Minimum five (5) years of experience in... more

Oct 02 Registered Nurse RN, Utilization Review Right Solutions Harrison, MT

requiring medical services. This Registered Nurse RN, Utilization Review position ... duties. The Registered Nurse RN, Utilization Review professional will perform nursing... more

Sep 27 Temp HEDIS RN Medical Record Reviewer Boston Medical Center Healthnet Plan Manchester, NH

by supplementing administrative scores by medical record review scores. Measurement is ... Experience: Minimum 3 years of HEDIS medical record review experience. Experience... more

Sep 24 Utilization Review-Nurse Korak Global Healthcare Services Glen Burnie, MD

in Utilization Review/ Case Management Nurse- Appeals & Grievances/Outpatient Nurse/ ... Outpatient-The Utilization Review Nurse is responsible for receipt, screening... more

Sep 18 Physician- Medical Review - Part-Time (232024-005) Concentra Las Vegas, NV

-Assists the Concentra Physician Review Medical Director with recruiting, ... for utilization review, chart reviews, medical necessity, appropriateness of care... more

Aug 22 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

Aug 14 Clinical Care Reviewer UM, RN AmeriHealth Charleston, SC

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

Aug 04 Medical Review Coordinator (RN Medical Review Coordinator) State of Oregon Salem, OR

is with the Division of Medical Assistance Programs (DMAP), which is part of the Oregon Health Authority (OHA). There is two permanent, full-time position located in Salem (500... 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 17 MANAGER,CLINICAL RESOURCE CENTER (Utilization Review/Pre-Cert) RN BSN Temple University Health System Philadelphia, PA

RN-LIC - 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

Jul 07 Medical Bill Review Nurse (RN) Healthcare Scouts Haltom City, TX

position. In this role as a Medical Bill Review Nurse, you will engage in case review ... care plans are established, managed and medical personnel have followed the... more

Jul 05 Healthcare Physician Practice Consultant / Medical File Review Nurse - Jefferson County UnitedHealth Group Watertown, NY

Requirements Requirements: - Medical/clinical background desirable (NP) - 7+ years associa ... nurse, nurse practitioner, RPN, Medical File Review, Medical Coding Careers with... more

May 30 CASE REVIEW COORDINATOR, RN, Per Diem Faulkner Hospital Boston, MA

communities by offering comprehensive medical, surgical and psychiatric care, as ... in-patient Case Management and Utilization Review. Basic computer knowledge. Experience... more

Jobs by Simply Hired