A company is looking for a Utilization Review Registered Nurse.Key Responsibilities : Complete medical necessity and level of care reviews using clinical judgment and guidelinesObtain necessary information to assess member's clinical conditionRefer members for further care engagement when neededRequired Qualifications : Active, unrestricted RN licensure in the United States or compact multistate unrestricted RN licenseAssociate Degree in Nursing or equivalentAbility to obtain additional state licenses as needed1+ year of utilization review experience in managed care2+ years of clinical experience, including 1+ year in an acute care setting
RN Utilization Review - Oregon Licensed
A company is looking for a Utilization Review Registered Nurse (RN) for a remote position. ...
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...
Utilization Review RN - WV Licensed
A company is looking for a Utilization Review RN - Medicare to collaborate with the Medical Director and drive improvements in care management. ...
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. ...
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...
Case Mgt Utilization Review Rn - Remote
Case Mgt Utilization Review RN - REMOTEClick Here to Apply OnlineJob DescriptionLocation: Steward Health CarePosted Date: 12/6/2023The Care Manager assumes primary responsibility for documentation of appropriate medical necessity for the inpatient status or placement in observation. Assists in the d...
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. This RN effectively communicates with internal and external clinical professionals, efficiently organizes the financial...
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. ...
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. ...