Utilization review nurse near me

Prime Staffing is seeking a travel nurse RN PACU - Post Anesthesia Care for a travel nursing job in New Orleans, Louisiana. Job Description & RequirementsSpecialty: PACU -...

Role Overview The Supervisor Behavioral Health Utilization Management Review manages a remote team of 10 Behavioral Health Utilization Management Reviewers who process prior authorization requests and concurrent reviews...

The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while managing treatment costs. This position involves coordinating, assessing, and authorizing treatment...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician...

Role Overview The Supervisor Behavioral Health Utilization Management Review manages a remote team of 10 Behavioral Health Utilization Management Reviewers who process prior authorization requests and concurrent reviews...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

SUMMARY: Reports to the Director of Care Management or designee. Conducts surveillance over medical necessity of patient care records. In collaboration with the physician of record and the Utilization Review Committee physician ensures the...

It's more than a career, it's a calling. IL-REMOTE Worker Type: PRN Pay Range: $35.81 - $53.72 Pay Rate Type: Hourly SSM Health...

Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking...

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach...

Quality and Utilization Management Specialist What you will be doing: The Quality and Utilization Management Specialist will be the owner of, and the primary individual responsible for interdepartmental coordination of...

Our Client, a Health Insurance company, is looking for a Utilization Mgmt Coordinator I for their Remote location. Responsibilities: Supports the Utilization Management clinical teams by assisting with...

Agency Dept of Administration Division Youth Advocacy , Involvement Office Job Classification Title S-Education & Training (S) Position Number 60013976 Grade TS...

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other...

Salary : $163,966.66 - $204,958.26 Annually Location : City of Milpitas, CA Job Type: Full-Time Remote Employment: Flexible/Hybrid Job Number:...

We are seeking highly skilled and detail-oriented Utilities Lawyers to support our clients, many of which are leading energy providers across the U.S. This is a remote opportunity for attorneys with strong regulatory and...

The Vice President, Electric Utilities will report to the Sr. Vice President, Utilities and will lead a strategic, Enterprisewide Energy team charged with integrating transmission solutions to enable large-scale data center developments across the...

CERIS in Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other...

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health,...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach...

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead...

irth Solutions, a leading provider of cloud-based solutions that improves the resiliency of critical infrastructure, including its flagship 811 ticket management system “UtiliSphere”, is hiring an Account Executive with demonstrated...

As Physician Reviewer/Advisor you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other...

Committed to serving global societal needs. ASTM International positively impacts public health and safety, consumer confidence, and overall quality of life. We integrate consensus standards - developed with our international membership of...

Job Type Full-time, Contract Description HaystackID is seeking actively licensed attorneys for document review projects we are immediately staffing. DETAILS: Pay Rates: $24-$26 per...

Job Description Adams & Martin Group is looking to speak with Document Review Attorneys interested in knowing about upcoming opportunities for projects through year-end and into 2026! Location: Reviews are remote Duration:...

Job Family: CDI Specialist Travel Required: None Clearance Required: None What You Will Do: Second level reviewer responsibilities include comprehensive, clinical chart reviews...

Job description: Job Title: UM Review Assistant Duration: 6+ Months on w2 with no benefits Job Location: Remote (California) Job Summary: The Review Assistant role is pivotal...

Children and Family Services - Remote within ND - Quality Assurance Reviewer This position can be located anywhere in the state of North Dakota. Help the state's child welfare system achieve its...