Active PA Licensed RN required. Post Acute and Utilization Management experience required. General Summary. The. Utilization Review Nurse. plays a critical role in ensuring high-quality, cost-effective care transitions for patients requiring post-acute services. This role focuses on utilization management, discharge planning, and coordination of care to the most appropriate setting. The candidate collaborates closely with hospital utilization rev...
Overview. Hello Humankindness. . Chandler, Arizona. . has a stable suburban population with an economy anchored by many large financial, and high tech companies. Located southeast of Phoenix, Chandler is a skillfully developed community of friendly, diverse neighborhoods with expansive parks, great schools, convenient shopping, and excellent career opportunities. For more than 50 years, Dignity Health’s. Chandler Regional Medical Center. has focu...
Overview. Hello humankindness. Dignity Health’s. Mercy Gilbert Medical Center. is nationally known for our holistic approach to medicine, and here, you are a part of a “golden thread” of compassionate care that connects staff and patients. While walking through the Healing Garden–with it’s intertwined pathways, garden areas and fountains–you’re reminded of our dedication to honoring the whole person. Embracing total well-being, then seeing patien...
Overview. Hello humankindness. Dignity Health’s Mercy Gilbert Medical Center is nationally known for our holistic approach to medicine, and here, you are a part of a “golden thread” of compassionate care that connects staff and patients. While walking through the Healing Garden–with it’s intertwined pathways, garden areas and fountains–you’re reminded of our dedication to honoring the whole person. Embracing total well-being, then seeing patients...
We are seeking a dedicated and experienced Utilization Management (UM) RN with NICU experience to join our team. Under the guidance of a designated manager, you will conduct telephonic reviews of hospital admissions, ensuring appropriate levels of care and promoting high-quality healthcare delivery. This role involves collaborating with healthcare providers to facilitate timely discharge planning, recommending alternative levels of care, and ensu...
This is full-time remote, but candidates must reside in IL or TX. Contract: 05/05/2025 to 12/31/2025. RN working in the. insurance. or. managed care. industry using medically accepted criteria to. validate the medical necessity and appropriateness of the treatment plan. This position is responsible for. performing accurate and timely medical review. of claims suspended for medical necessity, contract interpretation, pricing. and to initiate and/o...
This is full-time remote, but candidates must reside in IL or TX. Contract: 05/05/2025 to 12/31/2025. RN working in the. insurance. or. managed care. industry using medically accepted criteria to. validate the medical necessity and appropriateness of the treatment plan. This position is responsible for. performing accurate and timely medical review. of claims suspended for medical necessity, contract interpretation, pricing. and to initiate and/o...
COMPANY OVERVIEW. HealthAxis is a prominent provider of core administrative processing system (CAPS) technology, business process as a service (BPaaS), and business process outsourcing (BPO) capabilities to healthcare payers, risk-bearing providers, and third-party administrators. We are transforming the way healthcare is administered by providing innovative technology and services that uniquely solve critical healthcare payer challenges negative...
Job ID: JP00045397. Anticipated Start Date. 04/07/2025. Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date. Elevance Health. is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are pa...
FIND YOUR FUTURE. We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. Overview. The Utilization Review Nurse (URN) performs clinical review to determine the medical necessity of requested services. The URN obtains clinical information and utilizes Independent Health policy and/or applicable clin...
FIND YOUR FUTURE. We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. Overview. The Utilization Review Nurse (URN) performs clinical review to determine the medical necessity of requested services. The URN obtains clinical information and utilizes Independent Health policy and/or applicable clin...
Overview. Hello Humankindness. Chandler, Arizona, has a stable suburban population with an economy anchored by many large financial, and high tech companies. Located southeast of Phoenix, Chandler is a skillfully developed community of friendly, diverse neighborhoods with expansive parks, great schools, convenient shopping, and excellent career opportunities. For more than 50 years, Dignity Health’s Chandler Regional Medical Center has focused on...
