Utilization Review Nurse

We're looking for skilled Utilization Review Nurses (PHRN-USRN) to join our dynamic team and ensure medical necessity, cost-efficiency, and compliance with health plan policies and regulatory standards. QualificationsMust have active PHRN or USRN licenseMinimum of 1 year of acute care management in a hospital set upMust have 1 year of experience in...

e are seeking a detail oriented and experienced Registered Nurse (RN) to join our TEAM as a Virtual Utilization Review Nurse.You'll be responsible for reviewing medical records and clinical documentation to determine the medical necessity, appropriateness, and efficiency of healthcare services provided. You'll work closely with physicians, case managers, and...

Accesshealthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.QualificationsActive PHRN licenseat least 1 year of clinical nursing experience in utilization review or...

e are seeking a detail oriented and experienced Registered Nurse (RN) to join our PIONEER TEAM as a Virtual Utilization Review Nurse.You'll be responsible for reviewing medical records and clinical documentation to determine the medical necessity, appropriateness, and efficiency of healthcare services provided. You'll work closely with physicians, case...

We are looking for a PHRN Team Lead to oversee and support a team of Utilization Review Nurses in providing high-quality medical necessity reviews for our U.S. healthcare clients.This leadership role requires strong clinical knowledge, hands-on UR experience, and the ability to guide and motivate a team in a fast-paced, remote work environment.Key...

We are seeking a highly skilled and detail-oriented PH Registered Nurse (PHRN) to join our team.The ideal candidate will have hands-on experience with InterQual, MCG , NCD, and LCD GuidelinesKey ResponsibilitiesConduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria.Analyze patient records to determine the...

Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed. Responsibilities :Perform advanced level work related to clinical denial and utilization...

Company DescriptionStemz Healthcare, established in 2015, is dedicated to revolutionizing global healthcare services. Utilizing cutting-edge technology like Machine Learning (ML) and Artificial Intelligence (AI), we ensure the highest quality of patient care and operational efficiency. Our global presence is reinforced by our commitment to excellence and...

Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...

Accesshealthcare is looking for REGISTERED NURSE to be part of our growing teamQualificationsMust be Registered Nurse with Active licenseAtleast 1 yr hospital experienceExperience in Utilization Review is a mustExperience in Healthcare BPO is a definite advantageGood communication skillsCan work onsite at PasayWhy join Accesshealthcare?HMO on DAY 1ANNUAL...