Utilization review nurse near me

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward...

Job Description: Participates in the development and ongoing implementation of QM Work Plan activities. Improve quality products and services, by using measurement and analysis to process, evaluate and make...

At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With...

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** JOB DESCRIPTION: RN working in the insurance or managed care...

Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of...

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Physical Medicine and Rehabilitation provider with an active New York medical...

We are so glad you are interested in joining Sutter Health! Organization: SCP-Sutter Center for Psychiatry Position Overview: The Utilization Review/Discharge Planner (UR/DP) performs chart review to determine...

Overview: TekWissen is a global workforce management provider headquartered in Ann Arbor, Michigan that offers strategic talent solutions to our clients world-wide. Our client is a health insurance company. It offers...

We are looking for a Utilization Review Specialist to join our team! The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. The full UR function can be performed...

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...

Stella Mental Health is a leading provider of breakthrough mental health treatments for depression, PTSD, and anxiety. We utilize cutting-edge modalities, including ketamine infusions, intranasal esketamine (Spravato),...

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...

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission.

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...

About Sound: Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, APPs, CRNAs, and nurses...

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...

Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in...

About Curative Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0...

Job Profile Summary Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to...

Description ESSENTIAL FUNCTIONS: · Act as liaison between managed care organizations and the facility professional clinical staff. · Conduct reviews, in accordance with certification requirements, of insurance plans or other...

Remote position, however, candidates must reside in the State of TX or State of IL This position is a contract for about 9 months. Pay: $41/hour RN working in the insurance or managed care industry using medically accepted...

Overview This position is a responsible administrative and clinical role focused on organizing and tracking utilization review (UR) data for Alabama's Region IV mental health centers. Region IV includes the service areas of...

Company: Skyway Behavioral Health Title: Utilization Review Specialist (URS) FLSA Status: Exempt Location: Remote Skyway Behavioral Health is an...

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...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking a Utilization Review Nurse to perform frequent case reviews,...

Title - Utilization Management Policy Initiatives Nurse II Job Type - Permanent | Onsite | Remote | Hybrid (Role will be expected to work PST hours; candidate can live outside of California (but they must have a CA RN license).

POSITION SUMMARY: The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible for overseeing the daily operations of the Utilization Management (UM) and Clinical Appeal teams. This role ensures compliance...

Location: 100% remote, but candidates must reside on the West Coast and comfortable working PST hours. Description: We are seeking a dedicated and detail-oriented Utilization Management Registered Nurse...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

HJ Staffing is partnering with Impresiv Health , a specialized healthcare consulting partner, to find a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN). This critical...