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utilization review nurse Jobs

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Utilization Review Nurse

Cognizant - Tampa, FL

Cognizant is always looking for top talent. We are searching for candidates to fill future needs within the business. This job posting represents potential future employment opportunities with Cognizant. Although the position is not currently available, we want to provide you with the opportunity to express your interest in future employment opportunities with Cognizant. If a job opportun...

Utilization Review Nurse

Cognizant - Tampa, FL

The UM nurse assesses the medical necessity and quality of healthcare services by conducting the following types of requests: pre service, concurrent, and retrospective utilization management reviews. Roles and Responsibilities • Assesses the medical necessity, quality of care, level of care and appropriateness of health care services for plan members. • Conducts outr...

Utilization Review Nurse

Cognizant - Tampa, FL

The UM nurse assesses the medical necessity and quality of healthcare services by conducting the following types of requests: pre service, concurrent, and retrospective utilization management reviews. Roles and Responsibilities • Assesses the medical necessity, quality of care, level of care and appropriateness of health care services for plan members. • Conducts outr...

Utilization Review Nurse

UchicagoMedicine - Chicago, IL

Bring Your Passion to the Forefront: Utilization Review Nurse (RN), the Risk, Patient Safety & Compliance department, Full Time Days, University of Chicago Medicine in Hyde Park, Chicago, IL We're hiring a Utilization Review Nurse (RN) for the Risk, Patient Safety, & Compliance department for a Full-Time, Days shift for the Uni...

Utilization Review Nurse

Cognizant - Tampa, FL

The UM nurse assesses the medical necessity and quality of healthcare services by conducting the following types of requests: pre service, concurrent, and retrospective utilization management reviews. Roles and Responsibilities • Assesses the medical necessity, quality of care, level of care and appropriateness of health care services for pla...

Utilization Review Nurse RN

Saint Luke's Health System - KCMO, MO

"The best place to get care. The best place to give care." That is the Saint Luke's vision and, whether in a hospital, clinic, practice, or office, our more than 12,000 employees strive toward that vision every day. Saint Luke's employees are proud of our rich history and heritage, and that we remain the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint L...

Utilization Review Nurse

West Springs Hospital - Grand Junction, CO

Job Title: Utilization Review Nurse Location: Grand Junction, Colorado Employment Status: Full-Time Base Salary: Hiring wage depending on experience. Job Description : Work with payers (insurance companies, Medicaid, etc…) and obtain initial authorizatio...

Utilization Review Nurse (RN)

Enloe Medical Center - Chico, CA

POSITION SUMMARY: The Utilization Review Nurse has responsibility for managing Utilization Review services for all payer types and all locations. Promotes and evaluates effective utilization of health care services with the use of clinical guidelines/standards. Communicates with payers, physicians, and the case management team regarding patient status, projected length of stay, expected ...

Nurse Case Manager/Utilization Review Nurse I

State of Vermont - Springfield, VT

Overview The Department of Vermont Health Access (DVHA)'s mission is to improve the health and well-being of Vermonters by providing access to quality healthcare cost effectively. We have three priorities that support us in moving our mission forward: Adoption of value-based payments, management of information technology projects, and operational performance improvement. Our de...

RN - Patient Resource Mgr, UR (FT) Johnson City, TN

Ballad Health - TN

Job Definition SCOPE OF POSITION The RN - Patient Resource Mangager (Utilization Review) is responsible for the core functions of initial review, concurrent reviews, retrospective review, capacity management, regulatory compliance, resource management and obtaining MD clarification to avoid payer denial. The UR Nurse works to establish a professional relationship with ph...

RN - Patient Resource Mgr, UR (FT) Johnson City, TN

Ballad Health - TN

Job Definition SCOPE OF POSITION The RN - Patient Resource Mangager (Utilization Review) is responsible for the core functions of initial review, concurrent reviews, retrospective review, capacity management, regulatory compliance, resource management and obtaining MD clarification to avoid payer denial. The UR Nurse works to establish a professional relationship with ph...

RN - Patient Resource Mgr,UR (FT) Woodridge - Johnson City, TN

Ballad Health - Johnson City, TN

Job Definition SCOPE OF POSITION The RN - Patient Resource Mangager (Utilization Review) is responsible for the core functions of initial review, concurrent reviews, retrospective review, capacity management, regulatory compliance, resource management and obtaining MD clarification to avoid payer denial. The UR Nurse works to establish a professional relationship with ph...

RN - Patient Resource Mgr, UR (FT) Johnson City, TN

Ballad Health - TN

Job Definition SCOPE OF POSITION The RN - Patient Resource Mangager (Utilization Review) is responsible for the core functions of initial review, concurrent reviews, retrospective review, capacity management, regulatory compliance, resource management and obtaining MD clarification to avoid payer denial. The UR Nurse works to establish a professional relationship with ph...

RN - Patient Resource Mgr, UR (FT) Johnson City, TN

Ballad Health - Johnson City, TN

Job Definition SCOPE OF POSITION The RN - Patient Resource Mangager (Utilization Review) is responsible for the core functions of initial review, concurrent reviews, retrospective review, capacity management, regulatory compliance, resource management and obtaining MD clarification to avoid payer denial. The UR Nurse works to establish a professional relationship with ph...