Utilization review nurse near me

" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...

About Umpqua Health At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our...

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We...

Are you a bedside nurse seeking a change from the hospital setting? If you answered "yes", Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", may be the place for you! Alliant is recruiting...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

Immediate need for a talented RN Case Manager - Utilization Review - Onsite-Santa Clara, CA. This is a 03+ months contract opportunity with long-term potential and is located in...

Clinical Review Nurse - Concurrent Review (Remote) Must Be Located in Texas Schedule: Training: Monday-Friday, 8 a.m.-5 p.m. Post-Training: Tuesday-Saturday, 8 a.m.-5 p.m., or Sunday-Thursday, 8...

Clinical Review Nurse Job Description Join a dynamic team in a brand new 2026 program dedicated to managing the Duals line of business, combining Medicare and Medicaid benefits into a single comprehensive service. This program operates...

Salary range: $95,139 - $130,811 annually, based on qualifications. This exempt remote-hybrid position is eligible for a comprehensive benefits package which includes medical, dental, vision, a 403(b) retirement account, and a generous...

RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :...

COMPANY OVERVIEW At Harbor Health, we're transforming healthcare in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

The Clinical Quality Analyst identifies opportunities to improve patient related processes and outcomes. Responsible for coordination and implementation of performance improvement, quality initiatives and ensuring regulatory compliance. Engages in...

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of...

Department WMH FRIMA-RHC - 259441Worker Sub Type RegularWork Shift First Shift (United States of America) Pay Grade Job Description Job...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a...

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is...

Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and...

Your job is more than a job. The Collector is responsible for Collections and Denial Management ensuring the appropriate action is taken on assigned accounts in a timely manner resulting in positive resolution. Your Everyday. Maintains responsibility...

Company Overview: Upward Health is an innovative, multidisciplinary medical group dedicated to providing comprehensive in-home care around the clock. Our dedicated clinical team addresses physical, behavioral, and social health...

Employment Type: Full time Shift: Day Shift Description: NEW PAY RATES! Nurse - RNII -Cardiology Office - Phone Triage - Albany, NY -...

Job Type Full-time Description Join our team and earn a $4,000 sign-on bonus! | No Nights | No Weekends | Paid Holidays | | Competitive Pay | Bonus Potential | Generous Benefits/Retirement...

Food Production Requisition ID 2026-137591 Talent Areas Deli/ CMS Department Position Type Full-Time The Fresh Market & You: Our mission is to make everyday eating extraordinary for our guests, and we are looking for a new team member who will commit...

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a...

HJ Staffing is seeking a highly detail-oriented HEDIS Data Reviewer to join our team in support of Impresiv Health. Working under the direction of the Manager of Medical Record Review Operations, you...

Explore opportunities with Ochsner Home Health of New Orleans, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people...

ESSENTIAL FUNCTIONS Receives requests for imaging exams and acquire pre-certification if needed Obtains pertinent medical history/medical necessity and compiles for Radiologist protocol review Ensures...

[AP Clerk / Remote] - Anywhere in U.S. / Up to $33.17-hr DOE / Amazing Benefits - As an Accounts Payable Processor, you will: Process a high volume of invoices accurately and in a timely manner; Ensure all invoices are coded correctly and have...