Utilization review nurse near me

MSSI is seeking a travel nurse RN Utilization Review for a travel nursing job in Minneapolis, Minnesota. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: 13 weeks 24 hours per week Shift: 8...

Pyramid Consulting (Travel) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40...

A workforce solutions company is seeking a Registered Nurse-Case Review Specialist to provide support for Federal Occupational Health. This remote position requires extensive nursing experience and strong communication skills to ensure timely...

Registered Nurse As a Registered Nurse, you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

A healthcare solutions firm is looking for a Clinical Supervisor - RN for a remote role. This position primarily involves overseeing utilization management processes and ensuring compliance with clinical standards. The ideal candidate will hold an...

Job Opportunity: Registered Nurse Schedule: Monday to Friday - Eastern Time Location: Remote About the Role As a Registered Nurse, you will make an impact by performing advanced level work related to clinical denial...

Location: REMOTE - Must Work EST ( Required: NC license or Compact license ) SHIFT: Monday-Friday 8 am-5pm EST; No OT expectations Duration: 1 year (Possible contract to Hire) Job Description: Process authorization requests for TP product, will...

A healthcare provider is looking for an RN Coordinator Utilization Management to evaluate authorization requests and ensure proper care procedures. The position requires a current nursing license in Wisconsin and a minimum of four years of...

Registered Nurse - Case Review Specialist STGi is currently seeking a Registered Nurse-Case Review Specialist. The position is remote and open to candidates nationwide. Job Summary: Provides direct support...

A leading health solutions company is seeking a full-time Utilization Management Clinical Consultant. This remote role requires an active Arizona RN license and involves managing cases in a hospital setting. Responsibilities include conducting...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Job Title Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

A leading health solutions company is seeking a remote Registered Nurse for utilization management. Candidates must have an active Arizona RN license and at least three years of clinical experience. Responsibilities include coordinating healthcare...

A healthcare management firm is seeking a Medical Review and Appeals RN. This remote role involves reviewing and authorizing medical service requests, ensuring compliance with regulations, and implementing discharge planning. Candidates must have...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

A healthcare organization located in Marlton, New Jersey is looking for a qualified RN to ensure compliance for medical necessity through effective communication and documentation. The ideal candidate will have a minimum of three years of clinical...

Clinical Appeals and Grievances (analyzing, reviewing appeals/grievances)Clinical Interface/ Liaison (clinical problem solver with facilities, providers, resolution of issues concerning members, program definition and clarification)Clinical...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

Job Opportunity At Highmark Inc. Job Summary: This position reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical...

A health services provider is seeking a full-time remote Registered Nurse (RN) for a contract position in Chicago. The role involves validating medical necessity and appropriateness of treatment plans, focusing on claims review for medical...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Part-Time Utilization Review Nurse Remote (Nevada License Required) Location: Remote (Reporting to Carson City, NV) Schedule: MondayFriday, 8:00 AM12:00 PM PST Compensation: $40,000$45,000 annually (part-time, 20 hours/week)...

Nurse Case Manager II Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work. The...

Quality Assurance Position Pay: $34/hr Contract Details + Contract Duration: 520-hour contract-to-hire, long term opportunity Compensation: listed below, fixed rates (no opportunity for negotiation) Training Schedule:...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Virtual Health Center - Quality program This position is an onsite role and does not offer a hybrid or remote option Work Schedule: Full Time, 72.00 hours per pay...