RN - Utilization Review - Washington

This position will manage activities and staff of the Utilization Review department. · Supervise and evaluate the daily work of these teams in accordance with departmental and organizational policies. Provide education within the departments and the organization at large on clini ...

Lensa is seeking talented individuals to join their team as Utilization Management Reviewers. In this role, they will evaluate medical necessity for inpatient and outpatient services. · Conduct utilization management reviews by assessing medical necessity, appropriateness of care ...

We are hiring a Utilization Review Nurse to support our Utilization Review team by evaluating medical necessity requests and reviewing ongoing hospital stays. · ...

+Avalon Health Care Management is now hiring a Case Manager of Utilization Management and Authorizations to join our team. · +This role is critical to supporting our Skilled Nursing Facility (SNF) operations by managing authorizations, utilization management,, concurrent review, ...

Nuestro Utilization Management Reviewer evalúa la necesidad médica para servicios hospitalarios e internados. · Conducir revisiones de utilización evaluando la necesidad médica. · ...

+This nurse will support our Utilization Review team by evaluating medical necessity requests and reviewing ongoing hospital stays to ensure services are clinically appropriate, cost-effective, and aligned with plan guidelines. · + ...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. · They review medical records, treatment plans, and patient information to determine the necessity and appropriateness of ...

As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical skills to make a difference in our members' lives. · ...

If you are a Registered Nurse who has strong hospital Utilization Review (UR) experience and are ready to take the next step into a leadership role we would love to hear from you. · This position offers a hybrid schedule with most work performed remotely offering both flexibility ...

Responsibilities · The Psychiatric Institute of Washington is a152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of The Psychiatric Institute of Was ...

Johns Hopkins Health Plans is the managed care and health services business of Johns Hopkins Medicine. We are seeking a Utilization Review Registered Nurse to work from home, monitor the appropriateness of care received by plan members in various settings, evaluate member benefit ...

Responsibilities: · The Psychiatric Institute of Washington is a152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of The Psychiatric Institute of Was ...

We are currently seeking a dedicated Utilization Reviewer to join our dynamic team. · Why Choose Capital Region?The department stands out for its innovative, patient-centered approach and unwavering commitment to compassionate care. · High Reliability Organization (HRO) · As part ...

We are currently seeking a dedicated Utilization Reviewer to join our dynamic team. · Performs timely and accurate utilization review for all patient populations, · Communicates with clinical care coordinators and payors as needed regarding reviews and pended/denied days and inte ...

As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical skills to make a difference in our members' lives. · ...

The Utilization Review Nurse is responsible for reviewing and evaluating clinical information and documentation. · Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit determinations. · Evaluates documentation/information to ...

Requisition #:663165 Location:Johns Hopkins Health Plans, Hanover, MD 21076 Category:Nursing Schedule:Day Shift Employment Type:Full Time · Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion. · Make It Happen At Hopkins · Johns Hopkins Health Plans (JHHP) is the ...

Job summary · Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. · ResponsibilitiesConducts admission concurrent and retrospective case reviews to meet hospital objecti ...

Inova Fairfax Medical Campus is looking for a dedicated physician advisor to join the Utilization Review Advisor team.The role will conduct timely and compliant medical necessity reviews and assist with denials management in support of centralized system Utilization Review proces ...

Make it happen at Hopkins As a member of Johns Hopkins Medicine, Johns Hopkins Howard County Medical Center is a 266-bed acute care facility that has been serving the community for nearly 40 years. We can offer the most advanced, innovative technology with the collaboration and t ...