Skip to main content
X

Get jobs by email for this search

By continuing you agree to Monster's Privacy policy, Terms of use and use of cookies.

Utilization Review Nurse Jobs - Page 3

310 jobs

Description Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourcing and IT outsourcing se...
Description Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourcing and IT outsourcing se...
Description Amerigroup , a proud member of the Anthem, Inc. family of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities. Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates ar...
Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourcing and IT outsourcing services, inclu...
Facility Banner Health (Corporate) Shift Day Department Banner Health (Corporate) - Utilization Mgmt-Corp Position Type Full-Time Internal Code A COREHTF Street Address 2901 N. Central Ave Internal Code B CRITICND City & State US-AZ-Phoenix Posting Category Nursing - Case Management New Grad No Banner Health is currently seeking a Utilization Review Nurse to join the Utilization Review D...
Description16006732 Qualifications Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourci...
Description16006729 Qualifications Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourci...
Role: Utilization Review RN Assignment: Sr. Segment Location: Initial training period in Miramar, FL market office then work-at-home - must live in Southeast Florida area Humana’s dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a differ...
Company InformationSolid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.Job SummaryUnder moderate supervision, provid...
**Must have active RN Georgia/North or South Carolina ***Monday-Friday, 8-5 The two major functions of the Post Acute Care CaseManager are to ensure the customer is at the appropriate level of care, andtoinitiate and follow through in the discharge planning process. Given thecomplex nature and challenges of the US health system and CMS compliancerequirements, it is necessary to provide case mana...
The two major functions of the Post Acute Care CaseManager are to ensure the customer is at the appropriate level of care, andtoinitiate and follow through in the discharge planning process. Given thecomplex nature and challenges of the US health system and CMS compliancerequirements, it is necessary to provide case management interventions that areflexible, aligned with provider and facility plan...
Job Description: Seeking registered nurse for medical consulting company with utilization review and precertification experience. Prefer workers’ compensation background with knowledge of national guidelines such as CA MTUS/ACOEM and ODG. Preference in either Mountain or Pacific Time zones due to hours required for customers. The applicant must have computer, high speed internet and access to unl...
Requisition Number 16-3544 Post Date 6/28/2016 Title Utilization Review Nurse Job Family Nursing Subsidiary McLaren Flint Department 91590 - Utilization Management Location Flint Region City Flint State MI Full Time No Hours per 2 week pay period 0 Schedule Variable Weekends and/or Holidays Required No On Call Required No Description JOB SUMMARY The Utilization Reviewer partners wi...
KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Experience in Utilization Review. Experience uti...
Under moderate supervision, provide office based telephonic medical case management with emphasis on early intervention, return to work planning, coordination of quality medical care on claims involving disability and medical treatment as well as in-house medical reviews as applicable to claim handling laws and regulations. Responsible for helping to ensure injured parties receive appropriate trea...
Utilization Review Nurse (RN) Registered Nurse-2016-R0059878 Description Job Summary: It is the responsibility of the Case Manager/UM RNto provide integrated care management services, including both utilization management and case management, across the continuum of care. All current members are enrolled in Medicare Advantage plans. In the utilization management role, the Case Manager/UM RN ev...
Travel Utilization Review Nurse- Dallas, Texas Dallas is home to several local music festivals a year, and is just a few hours away from Austin! There are plenty of museums to visit, tons of great food, and even an amazing aquarium! Nice, warm weather, and plenty of things to do outdoors. Our hospital ranked among U.S. News' BEST Children's Hospitals in 10 specialties. They have an IMMEDIATE nee...
About This Position This position will review medical records, benefit, contractual and other guidelines to determine benefit coverage, medical appropriateness including, access, scope availability, and level of care considerations. Position updates and processes member records. Position Assists Member Services Dept, Claim Dept. and Physician and ancillary Providers and Health Plans with issues...
**Description:** ****RN with Multi-State License Required, Potential Remote Work**** Job Summary: It is the responsibility of the Case Manager/UM RN to provide integrated care management services, including both utilization management and case management, across the continuum of care. All current members are enrolled in Medicare Advantage plans. In the utilization management role, the Case Man...
**Description:** Job Summary: It is the responsibility of the Case Manager/UM RNto provide integrated care management services, including both utilization management and case management, across the continuum of care. All current members are enrolled in Medicare Advantage plans. In the utilization management role, the Case Manager/UM RN evaluates the appropriateness of medical services and facil...