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Oct 23 Registered Nurse (Utilization Review) Veterans Administration Saginaw, MI

of the RUR (Registered Utilization Review) Nurse include but are not limited to: ... and assistance regarding documentation of medical necessity, insurance review criteria,... more

Oct 23 Utilization Review Nurse Execu|search Group Jersey City, NJ

Utilization Review Nurse Utilization Review Nurse Location:  Jersey City, NJ Salary:  ... the Opportunity An Utilization Review Nurse is now needed at a healthcare facility in... more

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 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 20 Utilization Review Nurse I - (Cerritos Caremore Health Plan Downey, CA

of care, radiology review, or other such review processes that require an ... May access and consult with peer clinical reviewers, Medical Directors and/or delegated cl... more

Oct 20 Utilization Review Nurse - Full Time - Utilization Management Alaska Native Tribal Health Consortium Anchorage, AK

patient progress. Performs continuing review on medical records and identification ... Knowledge in conducting and reviewing medical record for medical necessity. more

Oct 18 Nurse -Clinical Manager of Medical Review United Medical Staffing Wauwatosa, WI

Job Description: Clinical Manager of Medical Review - Full-time - Milwaukee, WI - ... Mgr NGS Medical Mgmt: Manages medical review nursing staff and grievance and... 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 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 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 13 Medical Reviewer Record Expess Cincinnati, OH

reviewing medical records to create detailed medical chronologies. Experience in ... skills are required.Medical record review and chronology creation training will... 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 07 Medical Reviewer RN Blue Cross Blue Shield of Texas Fort Worth, TX

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

Oct 02 Medical Bill Review Healthcare Scouts Fort Worth, TX

medical saving solutions in medical bill review to the health, workers’ compensation, ... Registered Nurse, RN, Medical Bill Review, Work Comp, Disability Management, Claims... 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 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 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

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

Feb 23 Utilizat Review LPN Novant Health Charlotte, NC

initial, concurrent, and retrospective medical record reviews. Makes utilization ... * Licensure/Certification/Registration: Registered or licensed practical nurse currently l... more

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