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Utilization Review Specialist
Acadia External
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Burns, TN, 37029
... · Gather and develop statistical and narrative information to report on utilization, non-certified days (including ... · Facilitate peer review calls between facility and external organizations. · Initiate and complete the formal appeal ... - Jun 05
Travel Nurse - RN - UR - Utilization Review - / Week
BluePipes
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Harrington, DE, 19952
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 23
Review Nurse, Pediatric Review (Hybrid )
Alliant Health Solutions, Inc.
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Dunwoody, GA, 30346
... Review Nurse. The Pediatric Review Nurse, as a member of a professional multi-disciplinary team, is responsible for the complete medical review for Pediatric Programs as contracted by Alliant Health Solutions in the Medical Management and Utilization ... - Jun 28
RN - Registered Nurse - Utilization Review
CoreMedical Group
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Carmichael, CA, 95609
Job Details Client in CA seeking Registered Nurse: Utilization Review for the following shift(s): Days We are looking for a healthcare professional who is ready to provide exceptional patient care in this contract/travel role. Contract/travel ... - Jun 18
Travel Nurse RN - Utilization Review - per week
LanceSoft
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Santa Barbara, CA, 93190
LanceSoft is seeking a travel nurse RN Utilization Review for a travel nursing job in Santa Barbara, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 07/21/2025 Duration: 13 weeks 40 hours per week ... - Jun 28
Utilization Review Nurse
w3r Consulting
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Springfield, IL, 62777
... This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to Initiate and/or respond to correspondence from providers or members concerning medical ... - Jun 28
Registered Nurse - Utilization Review
Zenex Partners
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Los Angeles, CA, 90048
... improvement * BLS Preferred: * BSN * Prior work in an ambulatory healthcare setting * ACLS Primary Duties and Responsibilities • Review occurrence reports and the related pertinent medical records to determine opportunities for quality improvement. ... - Jun 16
System Utilization Management SUM Utilization Review RN
Alameda Health System
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Oakland, CA
Summary SUMMARY: The System Utilization Management [SUM] Utilization Review RN is responsible for ensuring the appropriate use of healthcare resources while maintaining high- standards of patient care. This role involves evaluating medical necessity ... - Jun 23
Utilization Management Review Nurse
AmeriHealth Caritas
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Baton Rouge, LA, 70873
... + Strong understanding of utilization review processes, including medical necessity criteria, care coordination, and regulatory compliance. + Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review ... - Jun 27
Medical Review Coordinator
Prime Healthcare
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Bristol, PA, 19007
... gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use sound judgment. Knowledge of Federal, ... - Jun 24