Wellspring Nurse Source is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Portales, New Mexico. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Dura...

American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Portales, New Mexico. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: ...

American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Baltimore, Maryland. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/10/2026 Durat...

Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with in 1979, the Valley Health System has grown to include , , Benefit Highl...

regulations including changes thereof Perform and plan reviews to verify adherence to quality standards and identify improvement... setting Work on conversion and acquisition teams to provide regulatory reviews and ensure requirements of commercial loans...

Medical Director who depends on a clean, well-documented case. Your reviews are the front line of quality, and your accuracy... coverage as required. What You'll Actually Do Conduct medical-necessity reviews: Evaluate requested services against benefit...

(CRU). The DA’s Conviction Review Unit (CRU) reviews the following kinds of cases: Actual innocence. The CRU reviews...

to ensure level of care and services are medically appropriate Performs prior authorization reviews related to mental health...

and implements product/process improvements. Supports Integrated Product Teams (IPT) and participates in design reviews. Represents...

through code reviews, testing, and refactoring. Stay up-to-date with industry trends and emerging technologies in identity...

care. Conducts admission reviews for Medicare, Medicaid beneficiaries, as well as private insurers and self pay patients... and retrospective clinical reviews with various payers, utilizing the appropriate guidelines as demonstrated by compliance...

, investigations, or reviews as the Inspector General deems appropriate. Supports ongoing OIG activities, including, but not limited.... Prepare designated checklists to document reviews completed of Florida Single Audit compliance. Advise the Department...

in design reviews. Represents the engineering community from initial build through the production and post-production...

for supervising the Design Plan and Field Review Unit which is responsible for office and field reviews of design plans...

for mental health and substance use services. • Conduct pre-certification, concurrent, discharge, and retrospective reviews...; initiate appeals and peer reviews as needed. • Monitor patient length of stay and communicate updates or issues to clinical...

regulations, and DNV accreditation standards. The UR RN performs utilization review activities, concurrent reviews...-stay, and discharge reviews for all patients based on: InterQual®, MCG, or payer-specific medical necessity criteria...

reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care... Responsibilities Manage a caseload of 50–75 patients, authorizing 15–25 cases daily and ensuring timely utilization reviews...

. Supports Integrated Product Teams (IPT) and participates in design reviews. Represents the engineering community from initial...

collateral reviews of semi-complex residential properties including unique homes, lake front properties, large acreage tracks...

performance, complete performance reviews, maintain vacation and work schedules, ensuring proper coverage, and complete timesheets... complex reviews of providers' financial records, administrative and accounting processes; develops and implements Time...