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Bill & Melinda Gates Foundation

Seattle, Washington

Helen Keller Intl.

Washington, D.C.

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Vanderbilt Health

Nashville, Tennessee

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Marshfield Clinic Health System

Minocqua, Wisconsin

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Marshfield Clinic Health System

Stevens Point, Wisconsin

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Vanderbilt Health

Nashville, Tennessee

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Providence

Santa Monica, California

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Vanderbilt Health

Nashville, Tennessee

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Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio

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St. Joseph's Health – Trinity Health

Syracuse, New York

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Vanderbilt Health

Nashville, Tennessee

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Marshfield Clinic Health System

Minocqua, Wisconsin

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Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio

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Marshfield Clinic Health System

Wausau, Wisconsin

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AdventHealth

Tavares, Florida

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Veterans Affairs, Veterans Health Administration

Las Vegas, Nevada

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Baylor Scott & White Health

Round Rock, Texas

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Baylor Scott & White Health

Killeen, Texas

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Vanderbilt Health

Nashville, Tennessee

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AdventHealth

Daytona Beach, Florida

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Miami, Florida

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Carondelet St. Mary's Hospital

Tucson, Arizona

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Utilization Review RN_Health Plan
*Seeking experienced UR or CM Nurses whom are dedicated to serving our Members*JOB SUMMARYThe Utilization Review Registered Nurse (RN) provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with the health plan, provider utilization and/or care coordination departments regarding medical necessity for prospective, concurrent, and retrospective reviews. Collaborates as a team to ensure that medical records support the level of services b


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