GQR Healthcare 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: 09/21/2026 Duration...

TalentBurst, Inc is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 09/28/2026 Durat...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Portland, Oregon. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, d...

required for moderately complex reviews, and collaborating with the health care team, members, and caregivers to assist in discharge planning... and cost-effective care; and developing and refining desk-level procedures (e.g., workflows). Performs utilization reviews...

Registered Nurse (RN), Quality Review Caser Manager Job Type: Full-Time | Days Schedule: Monday-Friday 8am-4:30pm; 1 weekend per month; Rotating holidays Your experience matters Southern Tennessee Regional Health System - Lawrencebu...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

, including HB 803 and SB 1234. Reviews and audits all permit documentation, including private provider submissions.... Supports oversight of private provider registration and statewide registry requirements. Reviews incoming permits...

and platform information, please check: - For any help or support, reach out to: PS: Our team reviews applications daily...

Quality Analyst (QA) is responsible for conducting quality audits of clinical appeal reviews and providing subject matter... expertise to support the accurate and timely processing of member and provider appeals. This role evaluates clinical reviews...

first-level utilization review of treatment authorization requests for injured workers. The HCP reviews clinical... and regulatory timeframes are met. - Manage multiple reviews, priorities, and deadlines in a fast-paced remote work environment...

Reviewer Specialist is responsible for performing clinical and medical necessity reviews to support the timely and accurate... comprehensive clinical reviews of medical records and supporting documentation to evaluate medical necessity for appealed services...

) Position Summary The Clinical Reviewer Specialist is responsible for performing clinical and medical necessity reviews... License required. (Not encumbered only) Key Responsibilities Conduct comprehensive clinical reviews of medical records...

Required , you will be part of our Physician Advisory Team providing first-level initial admission and continued stay case reviews. The... admission and continued stay reviews utilizing InterQual and MCG using evidenced-based criteria to identify and support the...

that may require special handling. • Performs clinical reviews according to the policies and procedures of HealthHelp... to manage cases and document reviews. • Promotes business focus which demonstrates an understanding of the company’s vision...

- Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness...

in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking... Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews . This is a flexible, fully remote...

and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified... physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1–2...