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Utilization or Review or Grapevine jobs in United States

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Utilization Review Nurse

Actalent  –  Oakland Park, FL, 33336
... This role involves close interaction with Medical Directors and other Medical Management staff to direct utilization and capture data effectively. Responsibilities Review prior authorization requests for medical necessity and appropriateness, ... - Jun 22

Utilization Review Specialist

Acadia External  –  Columbia, MO, 65203
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement for the facility. ... Facilitate peer review calls between facility and external organizations. Initiate and complete the formal appeal process ... - Jun 20

Travel Nurse - RN - UR - Utilization Review - / Week

BluePipes  –  Villas, NJ, 08251
TRS Healthcare is seeking an experienced Utilization Review Registered Nurse for an exciting Travel Nursing job in Rosedale, MD. Shift: 5x8 hr days Start Date: ASAP Duration: 13 weeks Pay: $1992 / Week TRS Healthcare is seeking a Registered Nurse ... - Jun 18

Utilization Management Assistant

Cottingham & Butler  –  Dubuque, IA
... The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine ... - Jun 22

Travel Case Management & Utilization Review RN - per week

Nightingale Nurses  –  Tuba City, AZ, 86045
Nightingale Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Tuba city, Arizona. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date:07/14/2025 Duration: 13 weeks 40 hours per week Shift... - Jun 10

Registered Nurse - Utilization Management

Vantage Search Group  –  Barksdale AFB, LA, 71110
... or concurrent review will be required.Reviews previous and present medical care practices as needed for patterns, trends, orincidents of under or over utilization of hospital resources incidental to medical careprovided to beneficiaries. ... - Jun 22

Travel RN Care Coordinator (Utilization Review) - per week

IDR Healthcare  –  Shasta County, CA, 96001
IDR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Redding, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 07/08/2025 Duration: 13 weeks 40 hours per week Shift... - Jun 21

PRN - Utilization Review Clerk

Perimeter Healthcare  –  Jackson, TN, 38305
Job Description Please review the job description below and let me know if you see any changes need to be made for the Utilization Review Clerk JOB SUMMARY: The Utilization Review Clerk is responsible for obtaining initial and ongoing insurance ... - Jun 22

Travel Nurse - RN - UR - Utilization Review - / Week

BluePipes  –  La Grange, KY, 40031
TRS Healthcare is seeking an experienced Utilization Review Registered Nurse for an exciting Travel Nursing job in Louisville, KY. Shift: 5x8 hr nights Start Date: 07/07/2025 Duration: 13 weeks Pay: $2229.96 / Week TRS Healthcare is seeking a ... - Jun 18

LPN/ Utilization Review- CPHC

State of North Carolina  –  Wilmington, NC, 28412
... Position is a Utilization Review Licensed Practical Nurse position located at Central Prison Healthcare Complex in Raleigh, which houses approximately 1318 close-custody male offenders. The individual will review medical cases to confirm that ... - Jun 13
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