RN Utilization Jobs - 13,816 Job Positions Available

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we

The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient

Overview The Surgical Utilization Review Registered Nurse (UR RN) is responsible for conducting concurrent medical necessity reviews to ensure appropriate level-of-care determinations, regulatory compliance, and reimbursement integrity. This position serves as a liaison between physicians, advanced practice providers,

CompanyArchimedes About UsArchimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job application: Provide all of your employment history, education, and licenses/certifications/registrations.

Primary Location: Peace - Louisville Address: 2020 Newburg Rd.Louisville, KY 40205 Shift: First Shift (United States of America) Job Description Summary: UofL Health is a fully integrated regional academic health system with five hospitals, four medical

Its more than a career, its a calling.OK-REMOTE Worker Type:Regular Job Summary:Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital

Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles

Utilization Review RN at Providence Health Plaza. Utilization Management covers 7 days/week, including holidays. This posting is not for a specific job vacancy. It serves to establish a place for current or future interested applicants to apply for Utilization Review

Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric, adolescent, young adult, adult and geriatric patients. Incumbent of this position

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective

When you join the growing BILH team, youre not just taking a job, you’re making a difference in people’s lives.Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission status

Job Description:The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet

Job Description:The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired

Job Description:The Complex Discharge Planner plays a vital role in managing patient flow from Concord Medical Center (CMC) and Walnut Creek Medical Center (WCMC) to post-acute care settings, including Skilled Nursing Facilities (SNFs), Residential Care Facilities

Job Description:The Complex Discharge Planner plays a vital role in managing patient flow from Concord Medical Center (CMC) and Walnut Creek Medical Center (WCMC) to post-acute care settings, including Skilled Nursing Facilities (SNFs), Residential Care Facilities