Utilization review - managed care nurse jobs & Careers

Description Summary: The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety of pre-admission,...

** Student Loan Repayment Up to $20,000   ** Licensure and Certifications Reimbursement   ** Tuition Reimbursement     ** Robust and comprehensive benefit package At ShorePoint Health, we’ve cultivated an environment that nurtures professional...

NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations , a chi...

Assistant Nurse Manager Emergency Department Adult Emergency Room Saint Peter's is the 5th hospital worldwide to earn Magnet status SIX times in a row. Our team of award-winning nurses is growing, and we are looking for talented, compassionate RNs to join our team. T...

Description Five years recent relevant clinical experience in an acute care facility required. Strong Interpersonal skills and ability to work with patients, families, providers, peers, and other departments required. Ability to use word processing and computer spread...

The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Resource Management, including but not limited to daily review of medical records to determine appropriateness and medical nece...

Description Summary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison an...

The Emergency Department Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Resource Management, including but not limited to daily review of medical records to determine appropriate...

Title: Registered Nurse Work Location: Detroit, MI, 48226 Duration: 5 Months Job Type: Contract Pay Rate: $37-37.00/hr Job Description: Perform prospe...

This is a remote 6 month renewable contract with benefits with an insurance company must have active NC license or company license The Case Manager coordinates the care an...

Job Description: Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. Conducts/delegates the assessment and reassess...

Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area's leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, hom...

Job Description: Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. Conducts/delegates the assessment and reassessme...

Case Management Director - Ottumwa, IA 52501 SUPERVISES – Case Managers and Social Workers Must-Haves Graduate of a program of Registered Nursing. Mini...

Title: Registered Nurse-Review Analys Work Location: Detroit, MI, 48243 Duration: 12 Months Job Type: Contract Work Type: Onsite Training and later Remote D...

POSITION SUMMARY: Under the supervision of the Nursing Director, the Nursing Supervisor will provide culturally competent medical, services to low-income adult individuals ...