Description Utilization Review RN at Providence Health Plaza. Utilization Management covers 7 days/week, including holidays. This posting is not for a specific job vacancy. It serves to establish a place for current or future interested...

Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/24/2026 Duration: 13 weeks ...

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Palo Alto, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/3...

Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/24/2026 Duration: 21 weeks ...

. Documentation and Reporting: Document findings from utilization reviews in the appropriate systems and ensure accurate record...

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...

How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays... organizations, external reviews, and other payers. Communicate with physicians to schedule peer to peer reviews. Accurately report...

only and are not intended to describe every function that may be performed in the job level. Reviews all appraisals and appraisal waivers... Reviews all staff and fee appraisers' appraisal reports and appraisal waivers to make sure they have sound logic, have applied...

. ** This is a Monday to Friday fully onsite role** Key Duties and Responsibilities: Reviews executed batch records and provide...

comprehensive admission and continued-stay reviews for inpatient and observation cases using facility-approved criteria and payer... assessment, organizational and problem-solving skills; strong time-management and ability to handle high-volume UR reviews...

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

, transition of care, and discharge reviews in a timely manner.Maintains case files in prescribed manner.Completes admission...

, and other critical information. Coordinate technical reviews with clinical, administrative, legal, and public affairs subject-matter...

, complex, or non-standard cases and complex medical determinations. Support AMC questionnaire reviews, ad hoc FMLA record... reviews, and EEO case support (including fact-witness participation, if requested). Misc: Government-Furnished Equipment...

Audit, Compliance, or Information Security. Hands-on experience managing User Access Reviews (UAR), certifications... governance, entitlement reviews, and IAM controls in regulated environments. Technical Skills Identity Governance...

positive outcome and optimal reimbursement, through coordination of patient care, daily clinical reviews, quality documentation... reviews with all payer types (Managed Medicare, Managed Medicaid and commercial) to secure authorization for continued...

clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy... appeals are completed thoroughly and on a timely basis. Interface with managed care organizations, external reviews...

requirements and performance expectations. Perform prospective, concurrent, and retrospective utilization reviews and first-level... prospective, concurrent, and retrospective utilization reviews. Ability to conduct first-level determination approvals using BSC...

and technical reviews, support monthly metrics development and submittals. Support by driving efficiency in the aircraft...

Description: In this role the Genetic Counselor will do the following: Perform pre service utilization reviews...