Manager Utilization Review - Washington

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

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

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 ...

+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. · + ...

+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, ...

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 ...

· The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effec ...

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 ...

· The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effecti ...

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 ...

As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical, managed care, utilization review and verbal/written communication skills to make a difference in our members' lives. · Work-life balance - This is a remote role ...

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 ...

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 ...

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 ...

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. · ...

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 ...