Join to apply for the Utilization Review Nurse - RN role at TapTalent.ai Join to apply for the Utilization Review Nurse - RN role at TapTalent.ai We're Hiring: Utilization Review Nurse - RN! We are seeking a dedicated and experienced Utilization Review Nurse (RN) to join our team. The ideal candidate will possess clinical expertise and a strong understanding of healthcare regulations to ensure optimal patient care while managing resource utilization effectively. We're Hiring: Utilization Review Nurse - RN! We are seeking a dedicated and experienced Utilization Review Nurse (RN) to join our team. The ideal candidate will possess clinical expertise and a strong understanding of healthcare regulations to ensure optimal patient care while managing resource utilization effectively. Location: 100% remote - but ust be residing and licensed in IL or TX Role: Utilization Review Nurse - RN Description 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/or respond to correspondence from providers or members concerning medical determinations. Required Qualification: Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases. Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills. Registered Nurse (RN) with unrestricted license in state. 3 years clinical experience. Ready to make an impact? Apply now and let’s grow together! Seniority level Seniority level Mid-Senior level Employment type Employment type Full-time Job function Job function Other Industries IT Services and IT Consulting Referrals increase your chances of interviewing at TapTalent.ai by 2x Sign in to set job alerts for “Utilization Review Nurse” roles. Arlington Heights, IL $70,000.00-$75,000.00 1 week ago Elmhurst, IL $70,000.00-$75,000.00 1 week ago Park Ridge, IL $70,000.00-$75,000.00 1 week ago Des Plaines, IL $70,000.00-$75,000.00 1 week ago Cicero, IL $70,000.00-$75,000.00 1 week ago Downers Grove, IL $76,207.00-$117,662.00 1 month ago Registered Nurse - RN / Step Down Unit - TELE-P Manager, Clinical Care Case Management - Remote Chicago, IL $81,000.00-$116,000.00 1 week ago Registered Nurse - FT Day - 2N: Cardiac Tele Downers Grove, IL $66,575.00-$142,576.00 5 days ago Registered Nurse - FT Night - 2N: Cardiac Tele Cicero, IL $70,000.00-$75,000.00 1 week ago Des Plaines, IL $70,000.00-$75,000.00 1 week ago Arlington Heights, IL $70,000.00-$75,000.00 1 week ago Park Ridge, IL $70,000.00-$75,000.00 1 week ago Oak Lawn, IL $70,000.00-$75,000.00 1 week ago Registered Nurse (RN)-Telemetry .6 7p to 7a We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr TapTalent.ai
...insurance Paid time off Vision insurance Negoshian's is looking to add to the team! We are looking for a experienced diesel mechanic. Requirements: Pass a pre employment drug test and random drug tests Must have own tools, required Certified in brakes...
...By applying, you consent to your information being transmitted by Jooble to the Employer, as data controller, through the Employers data processor SonicJobs. See pae Privacy Policy at and Terms & Conditions at and SonicJobs Privacy Policy at and Terms of Use at...
...Assured Nursing is seeking a LPN / LVN for a travel job in Tyndall, South Dakota. Job Description & Requirements ~ Specialty: LPN / LVN ~ Discipline: LPN / LVN ~ Start Date: 08/11/2025~ Duration: 13 weeks ~36 hours per week ~ Shift: 12 hours, nights...
...Job Description Drive For Russ MotorsRuss Motors is hiring full-time CDL Class A Company drivers and Owner Operators for local home daily routes based out of Tonawanda, NY. At least 2 years verifiable CDL experience is required. Full time routes available for Company...
...Class A Driver Bold Safe Trucking is a top employer of CDL Truck Drivers across the country. In addition to a great starting salary, we offer great benefits... ...transmissions only; No Automatic Restrictions Home Daily Driver guaranteed a minimum of 8 hours per day...