A company is looking for a Utilization Review RN - Medicare to collaborate with the Medical Director and drive improvements in care management.
Key ResponsibilitiesAssist in building and implementing care management review processesCollaborate with medical management team to enhance healthcare outcomes for membersEducate stakeholders to improve processes and strengthen network relationshipsRequired QualificationsCurrent unencumbered RN licensure with the appropriate state boardThree years of healthcare clinical experienceBachelor's Degree in Nursing or currently enrolled in a BSN programExperience with Medical Management for Medicare and / or Medicaid populationsUtilization Review experience preferred
Behavioral Health Utilization Review Clinician - OH Licensed
A company is looking for a Utilization Review Clinician - Retrospective. ...
Case Mgt Utilization Review RN - REMOTE - Utilization Review
Case Mgt Utilization Review RN - REMOTE. Assists in the development of physician profiles to identify over/under utilization patterns. Identifies and plans strategies to optimize inpatient length of stay and resource utilization. Certification/Licensure: RN license required; Certification in Case Ma...
Behavioral Health Utilization Review Clinician - Licensed
A company is looking for a Utilization Review Clinician - Behavioral Health. LCSW, LMHC, LPC, LMFT, LMHP, RN)Clinical knowledge of mental health and substance abuse treatment plans preferredExperience working with healthcare teams in reviewing mental health and substance abuse services preferred. ...
Utilization Review RN - Remote in TX - Contract
RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. ...
RN Utilization Review - IL
A company is looking for a RN-Utilization Review to ensure payors receive clinical information to support services provided by the hospital. ...
Case Mgt Utilization Review RN - REMOTE
Assists in the development of physician profiles to identify over/under utilization patterns. Identifies and plans strategies to optimize inpatient length of stay and resource utilization. RN license required; Certification in Case Management (CCM) strongly preferred. ...
RN Utilization Review II
Description: 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. Title: RN Utilization Review . This RN effectively communicates with internal and external clinical prof...
Case Management Utilization Review RN - REMOTE
Assists in the development of physician profiles to identify over/under utilization patterns. Identifies and plans strategies to optimize inpatient length of stay and resource utilization. RN license required; Certification in Case Management (CCM) strongly preferred. ...
Case Management Utilization Review RN - REMOTE
Assists in the development of physician profiles to identify over/under utilization patterns. Identifies and plans strategies to optimize inpatient length of stay and resource utilization. RN license required; Certification in Case Management (CCM) strongly preferred. ...
RN Utilization Review II
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. Title: RN Utilization Review . This RN effectively communicates with internal and external clinical professionals,...