Utilization Review RN Jobs | Glassdoor
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Utilization Review RN Jobs

7,622 Jobs

  • Aspire Health Plan – Monterey, CA
    22 days ago 22d
    The Manager of UtilizationReview will: Actively participate in organizational determinations of coverage upon receiving authorization… concurrent review as needed. For complex cases at SVMH and/or Natividad, may be required to do on site reviews for UM or QI…
  • Firely Pediatric Services – Harleysville, PA
    EASY APPLY
    $50k-$86k(Glassdoor est.)
    NEW
    RN/LPN Firely Pediatric Services - Harleysville, PA Firely Pediatric Services is seeking an RN/LPN for a full-time day and… results as needed. Skills and Qualifications: · Accredited RN/LPN license · Clinical skills, bedside manner, infection control…
  • 3.8
    RepuCare – Indianapolis, IN
    $46k-$59k(Glassdoor est.)
    NEW
    experience (Inpatient Continuous Stay Review). Keywords:RN, Registered Nurse, UM, Utilization Management, MM, Medical Management… provide an equivalent background. Requires current unrestricted RN license in applicable state(s). SKILLS: Requires strong oral…
  • 4.0
    MedPartners – United States
    $66k-$82k(Glassdoor est.)
    4 days ago 4d
    Description CASE MANAGEMENT Title: UtilizationReviewRN Do you want to work for a company that offers CONSISTENCY, RELIABILITY… for experienced, Acute Care Case Managers focused on UtilizationReview & Discharge Planning. These positions require: 2+…
  • 3.4
    Presbyterian Healthcare Services – Albuquerque, NM
    7 days ago 7d
    expertise performing utilization management functions (i.e., prior authorization, medical claims review to include prospective… appropriate setting. Utilizes clinical skills to to coordinate, document and communicate all aspects of the utilization/benefit management…
  • 4.2
    Woman's Hospital – Baton Rouge, LA
    EASY APPLY
    NEW
    years prior work experience in UtilizationReview/Case Managment with emphasis on concurrent review process is also required.… Post Date 4/5/2017 Title UtilizationReview Analyst FLSA Type Non-Exempt / Part-Time Minimum Salary $25.20 Maximum…
  • 3.6
    Stormont-Vail Healthcare, Inc. – Topeka, KS
    $50k-$63k(Glassdoor est.)
    13 days ago 13d
    an accredited school of nursing; BSN or MSN required; current RN licensure in the State of Kansas required; at least five years…
  • 3.4
    MultiCare Health System – Tacoma, WA
    $65k-$83k(Glassdoor est.)
    8 days ago 8d
    Position Summary: The UtilizationReview (UR) Specialist is responsible for concurrent utilization management activities to… to a defined patient population. The UtilizationReview (UR) Specialist is a link between the patient, health care team, organization…
  • 4.4
    Northeastern Vermont Regional Hospital – Saint Johnsbury, VT
    $48k-$60k(Glassdoor est.)
    11 days ago 11d
    between 7pm-7am Job Details Looking for team oriented RN to join the ED team! Highlights: · Competitive Pay: Per… required. · ACLS certification required. · Current Vermont RN licensure required. Apply Apply Now…
  • 3.1
    CAMC Health – Charleston, WV
    $45k-$56k(Glassdoor est.)
    27 days ago 27d
    quality patient care, reduce length of stay and resource utilization and ensure reimbursement drawing on a broad clinical and… Level of Experience 7 - 10 Years - Utilization/Case Management. 7 - 10 Years - 5 yrs Clinical Experience…
  • 3.3
    SSM Health – Lake Saint Louis, MO
    $50k-$65k(Glassdoor est.)
    NEW
    Description Role Purpose: The Staff Nurse (RN) provides direct patient care in accordance with established policies… Qualifications: Degree from an accredited Nursing Program State of MO RN License BLS Customer Service abilities and effective listening…
  • 4.4
    Northeastern Vermont Regional Hospital – Saint Johnsbury, VT
    $48k-$60k(Glassdoor est.)
    8 days ago 8d
    plus." Employee review on Glassdoor.com Responsibilities: · Under the supervision of the providers, Lead RN and Practice Manager… pay period Job Details Looking for team oriented RN to join our Practice! Highlights: · Competitive Pay ·…
  • 3.4
    Riverside Health System – Newport News, VA
    $50k-$64k(Glassdoor est.)
    22 days ago 22d
    the leadership team to provide a comprehensive range of utilizationreview services associated with and in accordance with standards… experience. Related experience or basic understanding of utilizationreview.…
  • 3.2
    MemorialCare Health System – Fountain Valley, CA
    NEW
    Registered Nurse (RN) preferred. Licensed Vocational Nurse (LVN) with consideration made based on utilization management and related… complex clinical, benefit and network decisions. Apply UtilizationReview Management process to ensure continuity of care throughout…
  • 4.2
    Healthcare Support – Washington, DC
    6 days ago 6d
    Job Description Are you an experienced UtilizationReviewRN- Remote looking for a new opportunity with a prestigious healthcare… position for you! Daily Responsibilities: As a UtilizationReviewRN, you will collaborate with healthcare providers and…
  • 3.7
    Saint Luke's Health System – Kansas City, MO
    $49k-$61k(Glassdoor est.)
    Today 4hr
    Kansas and Missouri RN license. Prefer Bachelor's Degree and strong clinical background and UtilizationReview experience. This… Kansas and Missouri RN license. Prefer Bachelor's Degree and strong clinical background and UtilizationReview experience. This…
  • 3.5
    Commonwealth Care Alliance – Charlestown, MA
    $70k-$93k(Glassdoor est.)
    Today 11hr
    necessity criteria are met. Participates in utilization and case review as necessary. • Utilizes and depending on CCA internal resources… complexities that require intensive clinical support. The RN, Care Partner (Telephonic) provides longitudinal enhanced primary…
  • 2.7
    Oswego Hospital – Oswego, NY
    $50k-$63k(Glassdoor est.)
    17 days ago 17d
    REQUIREMENTS: RN with a minimum of 2 years clinical experience; minimum 1 year home care experience preferred. Utilizationreview, clinical… with St. Joseph's Hospital Health Center. POSITION: RN CLINICAL REVIEWER SHIFT: Full Time Monday – Friday Days $3,000 Sign…
  • 3.9
    KAISER – Seattle, WA
    $49k-$66k(Glassdoor est.)
    27 days ago 27d
    Management, acute or payor-based UtilizationReview Experience Minimum Experience Requirements 3 years recent RN clinical experience in… Experience with health plans, telephonic case management, utilizationreview, hospitals, disease management. License/Certifications…
  • 3.6
    Dignity Health – Rancho Cordova, CA
    $99k-$130k(Glassdoor est.)
    NEW
    Job Summary: The UtilizationReviewRN will review medical records, benefit, contractual and other guidelines to determine… experience as an RN. Two (2) years experience in a medical insurance environment. Clear and current CA RN license. BS or BA…
  • 3.8
    RepuCare – Indianapolis, IN
    Today 5hr
    and standards. Requires a LPN, LVN, or RN; 2 years of clinical or utilizationreview experience; 1 year managed care experience… applying: Utilization Management - specifically around Initial Emergent Inpatient Review and Continued Stay Review's. Candidate…
  • 3.0
    UniMed Direct – Richardson, TX
    19 days ago 19d
    Description Looking for a RN role that allows you to work M-F and still miss rush hour? We are looking for a RN with at least 2 years…
  • 4.3
    Central California Alliance for Health – Salinas, CA
    $71k-$140k(Glassdoor est.)
    11 days ago 11d
    Nursing Facility (SNF) Program; and Works with Concurrent ReviewRN II’s to ensure training binder is updated with current processes… Supervises the daily activities of the Utilization Management (UM) Concurrent Review staff; Coordinates and implements effective…
  • 3.8
    Intermountain Healthcare – Salt Lake City, UT
    6 days ago 6d
    see what being a RN Care Manager at SelectHealth is all about! Job Description The UtilizationReview (UR) Nurse is responsible… Current RN license in state of practice. 3 years clinical nursing experience. 1 year in Managed Care, Utilization Management…
  • 3.3
    Desert Regional Medical Center – Palm Springs, CA
    $130k-$161k(Glassdoor est.)
    NEW
    and revising the UM Plan and promoting cooperation with utilizationreview standards by the medical staff c) Maintaining / facilitating… and the physician advisor on a regular basis regarding utilizationreview and/or quality issues d) Maintaining / facilitating communication…
  • 3.2
    The Menninger Clinic – Houston, TX
    $63k-$80k(Glassdoor est.)
    NEW
    recognizes limitations through self-appraisal and peer review. Effectively utilizes management and clinical supervision o Supports… or CCNE accredited RN program. BSN preferred. License/Certification: Current license to practice as RN in state of Texas…
  • 3.3
    Novant Health – Charlotte, NC
    $48k-$61k(Glassdoor est.)
    12 days ago 12d
    patients and families. The UtilizationReviewRN serves as a leader resource in the utilizationreview process. They collaborate… compliance. The UtilizationReviewRN coordinates and conducts initial, concurrent, and retrospective medical necessity reviews. All Utilization…
  • 4.3
    Central California Alliance for Health – Scotts Valley, CA
    $78k-$97k(Glassdoor est.)
    7 days ago 7d
    confidentiality of utilizationreview, quality management information and beneficiary identification; and Attending Concurrent Review Rounds… retrospective) review of acute in-patient care services using established criteria; 2. Participates in the Utilization Management…
  • 3.4
    Kelly Services – Oakland, CA
    NEW
    nutshell, our client is seeking a UtilizationReview Nurse (LVN or RN) to perform onsite reviews of urgent and continued stay requests… We are currently seeking to fill a UtilizationReview Nurse (LVN or RN) near you. This is a contract to hire position, depending…
  • 2.3
    Eastar Health System – Muskogee, OK
    $59k-$75k(Glassdoor est.)
    15 days ago 15d
    Responsible for utilizationreview. Conduct concurrent admission and continued stay reviews based on utilizationreview criteria including… the Professional Rescuer from the American Red Cross. UtilizationReview Certification preferred. Or can be a Social Worker with…
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