Talent.com
State Licensed Utilization Review Nurse
State Licensed Utilization Review NurseVirtualVocations • Chattanooga, Tennessee, United States
State Licensed Utilization Review Nurse

State Licensed Utilization Review Nurse

VirtualVocations • Chattanooga, Tennessee, United States
20 days ago
Job type
  • Full-time
Job description

A company is looking for a Utilization Review Nurse - Full-Time.

Key Responsibilities

Review and evaluate electronic medical records for emergency admissions and assess medical necessity

Apply clinical guidelines to ensure proper utilization of healthcare resources

Participate in discussions with physicians regarding documentation and admission status

Required Qualifications

Current and unrestricted RN license

At least 3 years of clinical experience in an acute care setting

At least 2 years of utilization management experience in acute admissions

Intermediate experience with InterQual and / or MCG criteria

Proficiency in medical record review in an electronic medical record (EMR)

Create a job alert for this search

Utilization Review Nurse • Chattanooga, Tennessee, United States

Related jobs
Maine Licensed Utilization Review Nurse

Maine Licensed Utilization Review Nurse

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Utilization Review Nurse - Remote.Key Responsibilities Review prior authorization requests for medical necessity and manage medical claims disputes Coordinate transiti...Show more
Last updated: 30+ days ago
Licensed Bill Review Nurse Specialist

Licensed Bill Review Nurse Specialist

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Bill Review Nurse Specialist who will utilize clinical acumen and medical review expertise to review workers' compensation medical bills. Key Responsibilities Analyze co...Show more
Last updated: 5 days ago
Nurse Practitioner (NP)

Nurse Practitioner (NP)

Medical Director Services PC • Dalton, GA, US
Full-time
Medical Director Services PC .Excellent salary will be offered, commensurate with experience.Assuring delivery of quality care services to all patients in a respectful and professional manner....Show more
Last updated: 30+ days ago • Promoted
New York Licensed Clinical Nurse Liaison

New York Licensed Clinical Nurse Liaison

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Nurse Liaison.Key Responsibilities Serve as a liaison for external groups and providers regarding clinical information Implement and manage procedures for tra...Show more
Last updated: 6 days ago
LPN Clinical Scheduler

LPN Clinical Scheduler

BrightSpring Health Services • Chattanooga, TN, United States
Full-time
US-TN-CHATTANOOGA | US-TN-CHATTANOOGA | US-TN-CHATTANOOGA | US-TN-CHATTANOOGA | US-TN-CHATTANOOGA.Adoration Home Health and Hospice. Adoration Home Health and Hospice.Responsible for providing admin...Show more
Last updated: 27 days ago • Promoted
Multi-State Licensed Review Nurse

Multi-State Licensed Review Nurse

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Preservice Review Nurse RN - Remote.Key Responsibilities Perform pre-service clinical coverage review of outpatient services Review and interpret clinical / medical reco...Show more
Last updated: 30+ days ago
Utilization Review Nurse - RN

Utilization Review Nurse - RN

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Utilization Review Nurse- RN.Key Responsibilities Conduct assessments and reviews for medical necessity of treatment requests and plans Process appeals for non-certifi...Show more
Last updated: 5 days ago
New Jersey Licensed Clinical Navigator

New Jersey Licensed Clinical Navigator

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Navigator - Cardiovascular - RN.Key Responsibilities Serves as a single point of contact for referring physicians, patients, and caregivers to provide resource...Show more
Last updated: 2 days ago
Minnesota Licensed Utilization Review Nurse

Minnesota Licensed Utilization Review Nurse

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Utilization Review Nurse responsible for managing pre-claim prior authorization denials for pharmacy and medical benefits. Key Responsibilities Review and assess prior a...Show more
Last updated: 5 days ago
Wisconsin Licensed Clinical Review RN

Wisconsin Licensed Clinical Review RN

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Claim Review RN - Medical Disability - Remote.Key Responsibilities Evaluate and process patient health information to determine outcomes for medical and specia...Show more
Last updated: 1 day ago
Case Manager, Patient Access

Case Manager, Patient Access

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Case Manager / PAP to support patient access initiatives.Key Responsibilities Assist patients in accessing therapies by verifying benefits and addressing reimbursement is...Show more
Last updated: 30+ days ago
Indiana Licensed Clinical Review Nurse

Indiana Licensed Clinical Review Nurse

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Perform concurrent reviews to determine member's overall health and appropriate level of care Review qua...Show more
Last updated: 6 days ago
California Licensed Care Review RN

California Licensed Care Review RN

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Care Review Clinician (RN).Key Responsibilities Assess services for members to ensure compliance with regulations and optimal outcomes Analyze clinical service request...Show more
Last updated: 2 days ago
Kansas Licensed Clinical Review Nurse

Kansas Licensed Clinical Review Nurse

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to assess member health and appropriateness of care Reviews quality and cont...Show more
Last updated: 1 day ago
Texas Care Management Processor

Texas Care Management Processor

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Care Management Processor who will provide non-clinical administrative support for care management functions. Key Responsibilities Facilitates administrative support inc...Show more
Last updated: 11 days ago
Utah Licensed Care Review RN

Utah Licensed Care Review RN

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Care Review Clinician (RN).Key Responsibilities Assesses services for members to ensure optimum outcomes and compliance with regulations Analyzes clinical service requ...Show more
Last updated: 4 days ago
New York Licensed Clinical Reviewer

New York Licensed Clinical Reviewer

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Clinical Review Clinician - Appeals.Key Responsibilities Performs clinical reviews to resolve and process appeals by analyzing medical records and clinical data Ensure...Show more
Last updated: 30+ days ago
State Licensed RN Medical Reviewer

State Licensed RN Medical Reviewer

VirtualVocations • Chattanooga, Tennessee, United States
Full-time
A company is looking for a Remote RN - Medical Claims Reviewer.Key Responsibilities Review medically complex claims, pre-authorization requests, appeals, and fraud / abuse referrals Assess payment...Show more
Last updated: 2 days ago