PRN Utilization Management RN Reviewer NE
IntelliResume
About This Role The PRN Utilization Management RN Reviewer at Cleveland Clinic Weston Hospital is responsible for performing utilization management activities, including admission and concurrent reviews, to ensure appropriate patient care and reimbursement. This role is ideal for experienced RNs who excel in analytical tasks and clinical judgment. Highlights Location: Weston FL Facility: Cleveland Clinic Weston Hospital Schedule: Per Diem, Day shift What You Will Do Perform admission and concurrent reviews to assess clinical performance. Conduct retrospective chart reviews and clinical systems reviews. Review medical records and provide clinical information to payers. Collect and report UM data. Manage concurrent denials appeals process. Interact with clinical teams and Physician Advisers. Recommend resource utilization and prioritize work. Apply medical necessity guidelines to monitor admissions and continued stays. Document appropriately in UM notes. Complete at least 25-30 reviews per day. Requirements Education: Graduate of an accredited school of nursing Experience: 3+ years of equivalent full-time clinical experience as a Registered Nurse Licenses & Certifications: Current RN License in Florida Basic Life Support (BLS) certification required About Cleveland Clinic Cleveland Clinic is a leading healthcare provider committed to delivering exceptional patient care. With a focus on innovation and education, they strive to provide a supportive environment for caregivers and patients alike. #J-18808-Ljbffr
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the PRN Utilization Management RN Reviewer NE in Florida, NY vacancy
- ...About This Role The PRN RN Case Manager at Cleveland Clinic Weston Hospital collaborates with inter‑professional teams to facilitate... ...RN clinical experience Two years of recent experience in utilization review, quality, or care management preferred Licenses & Certifications...ReliefDaily paidDay shift
IntelliResume
Florida, NY3 days ago - The Registered Nurse (RN) Pre-OP/Post Anesthesia Care Unit (PACU) is responsible for... ...requirements regarding his/her role in the Safety Management Program (Safety/Security), Infection... ..., Life Safety, Medical Equipment and Utility Systems, and his/her expected level of participation...ReliefMonday to Friday
- The Registered Nurse (RN) Post Anesthesia Care Unit (PACU) is responsible for providing... ...regarding his/her role in the Safety Management Program (Safety/Security), Infection Control... ..., Life Safety, Medical Equipment and Utility Systems, and his/her expected level of participation...ReliefMonday to Friday
- ...HomeCare as a Home Care Supervisor, RN! At BayCare, we are proud to... ...Weekend Work: Occasional PRN Shift available: BayCare... ...quality assurance program and utilization review is followed in accordance with... ...and physician concerns, risk management concerns and implements changes...ReliefFull timeWork at officeShift workWeekend work
- 6AM City, LLC is looking for a PRN Home Health RN to provide skilled nursing care in patients’ homes, ensuring accountability and collaboration with the interdisciplinary team. The ideal candidate must have a Registered Nurse license, significant experience, and demonstrate...Relief
- IntelliResume is seeking a PRN RN Case Manager at Cleveland Clinic Weston Hospital in New York, focusing on transitional care coordination. Ideal candidates will advocate for patients while ensuring compliance and participating in care development. The role requires strong...ReliefDaily paidDay shift
- ...Health System seeks a Hospital Care Coordinator‑RN for its New Port Richey facility, focusing on... ...advocacy and care coordination. This is a PRN position requiring RN certification, with responsibilities including managing a caseload and discharge planning. The role requires...Relief
- HCA Florida University Hospital is seeking a Supv House Admin PRN to oversee patient care delivery while demonstrating leadership and critical thinking skills. The position requires an RN with advanced cardiac life support certification and significant critical care experience...Relief
- ...Health is looking to add a Registered Nurse (RN) House Supervisor to our team at Baptist Medical Center Nassau. This is a PRN opportunity. Baptist Nassau is a highly... ...Job Responsibilities: Bed placement Crisis management Resource level knowledge of organ/tissue policy...Relief
- ...responsibility and clinical excellence. Hospital Care Coordinator‑RN Case Management Responsibilities Provides linkage, monitoring, planning and... ...Location: North Bay Hospital - New Port Richey, FL Status: PRN, As Needed Schedule: Days will vary; 8:00 AM - 4:30 PM...ReliefWeekend work
- ...Job Summary and Qualifications As a Case Manager, your role will be to support patients... ...patient and family interaction Qualifications RN with current state licensure; BSN... ...experience Certification in case management or utilization review preferred; InterQual experience...ReliefTemporary workFlexible hours
HCA Florida Lawnwood Hospital
Florida, NY2 hours ago - ...is seeking an experienced Registered Nurse (RN) in Florida. The role involves evaluating patient... ...services and ensuring compliance with management guidelines. Candidates should have strong experience in utilization review or case management and excellent communication...
- ...providers to maintain compliance with utilization management guidelines and optimizing treatment plans... ..., or Three (3) years of utilization review, case management, or third-party payer... ...Qualifications Active Registered Nurse (RN) license with 3+ years of experience in...
$30 per hour
...requisition id: JR101288\*PRN, Part Time, Full Time\*... ...as a Registered Nurse (RN), where you’ll bring... ...physician* Provides case management to an assigned group of... ...and procedures utilizing community resources as... ...clinical record/utilization review of medical records and...ReliefWeekly payDaily paidFull timePart timeImmediate startFlexible hoursNight shiftWeekend workWeekday workTeam Select Home Care
Florida, NY2 days ago- ...preferred Experience / Qualifications RN‑ Current RN licensure in the state of Florida... ..., self‑awareness, and self‑regulation; manages emotions so that they are expressed... ...performed when circumstances change. I have reviewed these job requirements and verify that I...ReliefLocal area
$35 - $39 per hour
Location: Clearwater Overview RN / Registered Nurse IPC, Hospice Position Type: Full-Time Remote/Virtual Position: No Coverage Area... ...Passion and Purpose as a Hospice IPC RN Salary: $35-39/hr Schedule: PRN Offer Based on Years of Experience About Us Caring for others is...ReliefFull timeRemote workFlexible hoursShift work- ...injuries, and neurological disorders. Job Type PRN Essential Duties and Responsibilities... ...in unit operations: Preparing schedules, managing budgets, and collaborating with other... ...Standards Promotes a healing environment and utilizes resources for optimum patient outcomes....ReliefDay shift
$15.87 - $25.38 per hour
...together we are even better. Schedule: PRN Shift: Day (United States of America)... ...Suite, and the ability to work in a matrix‑management environment to achieve organizational... ...adherence to efficient time management and utilization of patient resources. Interfaces with...ReliefHourly payWork experience placementWork at officeLocal areaFlexible hoursShift workNight shift- Memorial Healthcare System in Miramar, Florida seeks a seasoned Utilization Management RN to perform initial and continued stay reviews to determine medical necessity and appropriate level of care. You will collaborate with Case Management, support discharge planning, and...
- ...and apply online to join #teamMHSflorida.Learn more below.Summary:The Utilization Management RN uses evidence-based medical necessity screening tools to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests...Daily paidWork experience placementShift work
$72.78 per hour
...Join us Nurse Practitioner Psychiatric - PRN - Corrections experience required as NP Compensation... ...to patients, including medication management and crisis intervention services, while... ...formularies for therapeutic regimens and utilizes established procedures for admission,...ReliefContract work$57 - $74 per hour
...with your patients: appointments range from 20 to 60 minutes Strong focus on prevention and wellness, acute and chronic disease management Fewer administrative and insurance-related tasks Success is measured by health outcomes, not patient volume and billing (Not a Fee...ReliefMarathon Health
Florida, NY4 days ago- ...Home Dialysis Nurse (PRN / Per Patient Model) Premier Dialysis... ...support the onboarding and ongoing management of home dialysis patients.... ...clinical evaluations Coordinate and review lab work Manage medication... ...regularly with Lead RN regarding patient status and needs...ReliefHourly payFull timeRemote workFlexible hours
Premier Dialysis Inc
Florida, NY3 days ago - Overview Under the direction of the Director/Manager/Charge Nurse, the RN utilizes the nursing process, facilitates patient care, making nursing assessments and diagnosis, formulates care plans based on the diagnosis and implements and evaluates the plan of care. Qualifications...Relief
- ...seeking a caring and motivated RN to work with us at our Hospice... ...ill patient/family unit. Utilizes assessment, intervention and teaching... ...Care Coordinator/Care Center Manager. Why Join Empath Health? Earn... ...further information, please review the Know Your Rights notice from...Relief
Empath Health
Florida, NY14 hours ago - ...the highest quality of care for patients recovering from neurological conditions and injuries. The ideal candidate will have a valid RN license, significant nursing experience, and a commitment to patient-centered rehabilitation services. Join us in making a positive impact...Relief
- ...Supportive leadership Under the direction of the Chief Nursing Officer/Director of Nursing, Nurse Manager or Charge Nurse, the Registered Nurse (RN) is responsible for utilizing the nursing process while delivering, directing and supervising care to patients admitted to...ReliefFlexible hoursNight shift
- Illumia is looking for a dedicated PRN Nurse Practitioner to join our Advanced Illness Management team in New York. The ideal candidate will provide palliative care, develop individualized care plans, and work closely with a team of interdisciplinary providers. This position...ReliefDaily paidFull timePart time
- Exalt Health Rehabilitation Hospital Sarasota, LLC is seeking a Nursing Supervisor to enhance our team in delivering high-quality patient care. This key role involves supervising nursing staff, overseeing patient care, and ensuring adherence to rehabilitation best practices...Relief
- ...situations. Knows and maintains Code Blue/crash cart. Recognizes and utilizes safety precautions and procedures. Remains familiar with... ...Graduate of an accredited School of Registered Nursing. Active Florida RN license. Minimum of One (1) year experience in PACU or Critical...ReliefLocal areaImmediate start
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to PRN Utilization Management RN Reviewer NE. Be the first to apply!
