Utilization Review USRN - Taguig

The Utilization Review RN is responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary services to ensure medical necessity. · ...

The Utilization Review RN is responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary services. These reviews ensure medical necessity, · appropriate length of stay,intensity of service,and level of care,inc ...

We are looking for a Utilization Review Nurse who will perform medical necessity review of proposed prospective concurrent and retrospective cases such as medical treatments auto-injury related request hospitalization home care and inpatient/outpatient treatment plans for medical ...

The Manila-based Utilization Review Nurse USRN is responsible for reviewing the appropriateness of health care services requested and their coverage under the health insurance policies of participating Program Carriers providing health insurance. · The nurse will conduct care man ...

We are hiring for USRN - Utilization Review Author. · ...

The position involves training USRNs with bedside experience to enter the CPO industry as a CDI specialist. The role requires reviewing and analyzing clinical documentation and collaborating with healthcare teams. · ...

We are looking for a US Registered Nurse (USRN) with Utilization Management experience to support clinical review and authorization processes. The role requires strong clinical judgment, clear communication, · Active PHRN and USRN license (both required) · At least 6 months Utili ...

We are looking for a US Registered Nurse (USRN) with Utilization Management experience to support clinical review and authorization processes. · Active PHRN and USRN license (both required) · At least 6 months Utilization Management (UM) experience · Strong English communication ...

We are hiring US Registered Nurses (USRN) with Utilization Management (UM) experience to join our growing healthcare operations team in BGC. If you are looking to move into a non-bedside corporate healthcare role while still using your clinical expertise this is for you. · Review ...

We are hiring US Registered Nurses (USRN) with Utilization Management (UM) experience to join our growing healthcare operations team. · Active USRN license · At least 6 months Utilization Management experience · ...

We are hiring an experienced US Registered Nurse (USRN) to lead clinical review and utilization management teams within a healthcare services environment. · ...

We are hiring an experienced US Registered Nurse (USRN) to lead clinical review and utilization management teams within a healthcare services environment.This is a senior leadership role responsible for overseeing medical necessity reviews, claims analysis, and clinical complianc ...

The Prior Authorization Nurse will support the review and submission of prior authorization requests for behavioral health treatments, medications, or services. ...

As an Appeals and Grievances USRN one must be able to effectively process transactions assigned in a timely manner clarify complex transactions as needed ensure that quality of output and accuracy of information is maintained according to SLAs. · ...

As an Appeals and Grievances USRN one must be able to effectively process transactions in a timely manner clarify complex transactions ensure quality of output accuracy of information maintained according to SLAs. · ...

Responsable por brindar apoyo a las operaciones clínicas mediante el seguimiento de mensajes específicos del cliente. Realiza preguntas iniciales e remite los mensajes pertinentes al departamento adecuado para su resolución. · ...

Experienced USRN with a sign-on bonus of $100K. · ...

We are seeking a Prior Authorization Nurse to work in our Clinical Services department. · Must hold an active PHRN license. · Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review. · ...

This position requires experience in quality assurance with a focus on Medicare Part C Appeals. The ideal candidate will have strong analytical and problem-solving skills. · ...

College Graduate of BS Nursing Active PHRN & USRN Bachelor of Science in Nursing with active US license in at least one US state At least 1-3 years of acute hospital-based clinical experience in a medical surgical unit emergency department andor ICU Writing client-facing clinical ...