TravSource is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Arcata, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 10/26/2026 Duration: 13 ...

: 8 hours, days Employment Type: Travel Description In this remote role, you will conduct utilization reviews...

criteria, and annotation best practices. General Job Profile - Reviews the work of others. - Develops innovative approaches...

Description Providence Queen of the Valley Medical Center is committed to delivering top-notch healthcare, earning recognition from the Association of California Healthcare Districts (ACHD) Award in recognition of our outstanding contribu...

appraisals, prepares appraisal reviews and internal scorecards, and helps ensure appraisal activities are executed in alignment... with appraisal engagements and reviews. Conduct market research and provide analytical support to strengthen appraisal review...

appraisals, prepares appraisal reviews and internal scorecards, and helps ensure appraisal activities are executed in alignment... with appraisal engagements and reviews. Conduct market research and provide analytical support to strengthen appraisal review...

appraisals, prepares appraisal reviews and internal scorecards, and helps ensure appraisal activities are executed in alignment... with appraisal engagements and reviews. Conduct market research and provide analytical support to strengthen appraisal review...

appraisals, prepares appraisal reviews and internal scorecards, and helps ensure appraisal activities are executed in alignment... with appraisal engagements and reviews. Conduct market research and provide analytical support to strengthen appraisal review...

appraisals, prepares appraisal reviews and internal scorecards, and helps ensure appraisal activities are executed in alignment... with appraisal engagements and reviews. Conduct market research and provide analytical support to strengthen appraisal review...

appraisals, prepares appraisal reviews and internal scorecards, and helps ensure appraisal activities are executed in alignment... with appraisal engagements and reviews. Conduct market research and provide analytical support to strengthen appraisal review...

is responsible for conducting medical necessity reviews up to 12 hours per day, on any of the 7 days per week, utilizing Indicia... for Case Management, and performs clinical reviews through document review, discussion with physicians and collaboration...

as perform needed case reviews based on Federal, State and National guidelines. With the Quality, Safety and Risk caregivers...

. Job Summary: The Utilization Management Nurse (UM) Coordinator is responsible for conducting medical necessity reviews 24 hours... per day, 7 days per week. Utilizing mcg Indicia, clinical reviews are performed and clinical information shared with payers...

and accurate information. Uploads and monitors external reviews sent to external review companies. Corresponds with external... Management Platform with accuracy and timeliness. Facilitates and schedules Peer-to-peer requests. Reviews accuracy of member...

dispute reviews and submit relevant formwork related to re-pricing and network vendors. Review and audit bills to verify...

is met. The analyst performs quality reviews of random and targeted samples of completed readmission audits and applies expert... audits. Perform quality reviews of random and targeted samples of Clinical Readmission Review Auditor work to validate...

Review Specialist is an integral part of our team, completing quality reviews, performing high judgement investigations... us to better support our customers. Key job responsibilities - Completes quality reviews for various complex work streams. - Adheres...

team. This position is responsible for completing second-party case reviews, managing reports, identifying error trends...

manuals, or other resources as needed; initiates any actions necessary to correct deviations or violations. Reviews site... codes, ordinances, and engineering standards; reviews engineering studies, engineering reports, and cost estimates; reviews...

and accurate information. Uploads and monitors external reviews sent to external review companies. Corresponds with external... Management Platform with accuracy and timeliness. Facilitates and schedules Peer-to-peer requests. Reviews accuracy of member...