Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 h...

of MCG and Utilization Review requirements for concurrent and initial reviews Utilization review, Case management... equipment for chart reviews Performs inpatient and observation utilization reviews Reviews medical necessity using clinical...

TravSource is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tuba City, Arizona. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 09/07/2026 Duration: 13 ...

. 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...

regulatory agencies including but not limited to CMS, DPW, DHHS, HCFA, DOI and NCQA laws and standards. Perform peer reviews...

, and compliance with custodial agreements. Reviews loan (or collateral) documents, handles file processing and works with external...

. Responsibilities: Coordinates and completes the clinical reviews for all patient medical records while working closely with CMO...

internal routine and non-routine data reports for clients Reviews and audits simple routine laboratory data for a specific... with laboratory staff members to ensure all data Reviews are appropriately and efficiently corrected and documented Assists...

Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals... needs. Responsibilities: Coordinate phone calls, data entry, and tracking related to authorizations, expedited reviews...

and deliver for our customers. Position Summary Examines and reviews the Report it case submissions and data from the customer... scenarios and working on ad-hoc or special requests the program. Reviews Report it case submissions, attached pictures...

to conduct medical record reviews and to apply sound clinical judgment to claim payment decisions. Responsibilities may include...

by assisting with reviews on products that are the responsibility of the assigned team. Develop the ability to critically review..., and completing studies of product types or individual strategy reviews. Update analytical tools and dashboards to support business...

, coordinates customer service support activities. Performs on-site reviews and reports activities and resolutions of human... reviews. May represent department in official functions. Drafts letters, agendas, sample IRB applications, and guidance...

reviews to evaluate and implement services to meet client health needs; and promotes quality cost-effective physical therapy... a are driven to deliver great work. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Reviews medical records and physical therapy (PT...

. Candidates must be able to work during these hours. Position Purpose: Performs concurrent reviews, including determining member... of care being delivered to the member. Performs concurrent reviews of member for appropriate care and setting to determine...

and ongoing reviews pertaining to primary role (PA, ICM, DCM, PACM), appropriately applying clinical criteria (InterQual, policies...

standards Completes case reviews and analyses for contributing factors to the variance in care and/or complications including... and assists in preparing case reviews and projects for discussions Attend safety huddle to report any safety trends found...

across the greater Phoenix area. Responsibilities: Job Summary The Utilization Review RN Specialist reviews and monitors... and the utilization of ancillary services. Responsible for coordinating and conducting medical necessity reviews...

necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical... reviews will be completed as required by the payers, by accurately applying appropriate criteria sets. The UR RN (PRN...