RN - Utilization Management
Piedmont Healthcare
RN - Utilization ManagementJoin Piedmont to move your career in the right direction. Stay for the diverse teams you’ll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You’ll feel valued, motivated to be your best, and recognized for your contributions to exceptional patient outcomes. Piedmont leaders are in your corner, invested in your success. Our wellness programs and comprehensive total benefits and rewards meet your needs today and help you plan for the future.The purpose of this position is to ensure that acute hospital admission have the appropriate level of care, patient status, plan of care and meet medical necessity for an acute hospitalization. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensures that the patient's payer has the clinical information with which to authorize an acute hospital stay and the continued stay services to include covered days and associated services.Qualifications:Graduate of an accredited nursing school RequiredBachelors Degree of Science in Nursing PreferredMasters degree PreferredWork Experience:2 years of experience in an acute, post-acute or payer setting Required3 years of utilization review or care management experience PreferredLicenses and Certifications:RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required
- ...of prospective patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary documentation and communication with internal and...SuggestedReliefRemote workWeekend work3 days per week
- Piedmont Healthcare Corporate is seeking an RN to ensure appropriate level of care for acute hospital admissions, monitor... ...degree is a plus. Two years of relevant experience are expected, with utilization review or care management experience valued. #J-18808-Ljbffr PiedmontSuggested
- ...Experience 2 years of experience in an acute, post-acute or payer setting Required 3 years of utilization review or care management experience Preferred Licenses and Certifications RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required...SuggestedWork experience placement
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination... ...Qualifications: Must hold Compact Registered Nurse (RN) license in your state of residence Greater than one year...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome office$26.01 - $56.14 per hour
...Position SummaryUtilization management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Utilizes clinical experience and skills in a collaborative... ...Must have active current and unrestricted RN licensure in state of residence....SuggestedHourly payFull timeTemporary workWork at officeWork from homeAfternoon shift- A leading healthcare staffing agency in Atlanta is seeking a qualified Registered Nurse to join their team. This role involves reviewing patient admissions, providing clinical resources, and entering data into the system. The position offers a competitive salary and benefits...Monday to Friday
- ...clinical care and support. Care aspects include assessment, clinical management, communication, crisis prevention, regulatory readiness, and... ...healthcare delivery through a culturally sensitive process.Utilize clinical decision support tools and resources to recognize...
- ...is an extension of the Clinical Services management and leadership team with responsibilities... ...direct care responsibilities consistent with RN Senior for the role as assigned. Job... ...assigned patient care and treatments provided. Utilizes knowledge and resources regarding...Full timeTemporary workWork at officeMonday to FridayFlexible hoursNight shift
$60.2k - $107.4k
...care services are delivered. As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be... ...Required Qualifications:** + Active, unrestricted RN license in state of residence + 3+ years of...Minimum wageFull timeWork experience placementLocal areaRemote work- Cross Country Nurses is looking for a travel nurse RN Utilization Review for a 14-week assignment in Atlanta, Georgia. This role entails... ...MCG and LCD criteria. Candidates must have prior utilization management experience and bring their license on the first day. The position...Day shift
- ...Job TitleRegistry Utilization Review Nurse (PRN)Job DescriptionThe Registry Utilization Review... ...and/or physician advisor. The UR RN (PRN) will perform utilization review by... ...RN (PRN) will ensure proper use of Case Management Systems and workflows.Minimum QualificationsMust...Temporary workCasual workReliefShift work
$2,645 per week
Job Summary Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. The organization... ..., KP, and LCD criteria. The role requires prior utilization management experience, and candidates are required to bring their...Shift workDay shift- ...Job Description Job Description Job title: Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: Utilization Review RN - Target Review Health Plan Insurance (no acute care) BLS (AHA) RN state license \nCompany Description...Contract workShift work
- ...Description Job Description MDS Director- RN Top pay and benefits! Who we are... .... In this essential role, you will manage all aspects of the Minimum Data Set (MDS)... ...meetings including: daily PDPM, weekly CMI, Utilization Review, monthly Triple Check, and care plan...
- ...starlingphysicians.com, or @bmctotalcare.com. Job Description As an RN Care Manager with VillageMD, you will help us achieve our goals by... ...improve management of overall health and reduce unnecessary utilization Utilizing your clinical knowledge and deep...Work at officeLocal areaFlexible hours
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and to assess member needs to help them live healthier lives. You will collaborate with clinicians, interpret plans of care, and support discharge planning while...Remote jobWeekend work
- ...Job Description Job Description RN Supervisor Mon. – Fri. Full time $10,000... ...s by assessing, planning, delegating and utilizing independent judgment in directing staff to... ...skills ~ Strong organization and time management skills ~ Comply with current federal, state...Full timeLocal areaRelocation packageMonday to Friday
- ...preferred BLS Skills marked with * are preferredWork Settings:Acute HospitalLong Term Acute Care/Rehab/Skilled NursingCase Management/Utilization Review:Admission CriteriaCare coordinationDischarge PlanningUtilize InterQual CriteriaUtilize Milliman GuidelinesUtilization...Night shiftWeekend work
- ...determine hospice needs.Provides professional nursing care by utilizing all elements of nursing process.Assess and evaluate patient's status... ...toward self-sufficiency and optional comfort care.Acts as Case Manager when assigned by Clinical Supervisor and assumes responsibility...
- ...families. The Visit Nurse works in conjunction with the Nurse Case Manager, Director of Nursing (DON) and the Interdisciplinary Team to:... ...patient, attending physician and the Interdisciplinary Team, utilizing pharmacological and non-pharmacological methods of pain/symptom...
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and to identify solutions that help members... ...with Medical Directors to improve care progression. A RN license is required and weekend work is expected approximately...Remote jobWeekend work
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services and patient plans of care. The role offers remote work from anywhere in the U.S., with weekend coverage on a rotating basis and a salary range based on experience...Remote jobWeekend work
- UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services, assess member needs, and identify plans of... ...offering remote work within the U.S. The position requires an RN license, 3+ years of hospital nursing experience, and...Remote job
$25k
...caring community The Clinical Care Nurse (RN) is a clinic-based nursing role focused... ...of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and... ...activate patients are chronic disease self-management, particularly in DM, HTN, CHF and COPD....Full timeTemporary workWork at officeMonday to Friday$25k
...community The Clinical Care Nurse (RN) is a clinic-based nursing role focused... ...Transitions of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and... ...patients are chronic disease self-management, particularly in DM, HTN, CHF and COPD....Full timeTemporary workApprenticeshipWork at officeMonday to Friday$25k
...caring community The Clinical Care Nurse (RN) is a clinic-based nursing role focused... ...of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and... ...activate patients are chronic disease self-management, particularly in DM, HTN, CHF and COPD....Full timeTemporary workApprenticeshipWork at officeMonday to Friday- ...line and coordinate with surgeons and proceduralists. You will manage staffing, case flow, inventory and ensure nursing quality... ...with physicians, staff and leadership to optimize service line utilization. The role requires a nursing degree with Georgia licensure, BLS...
- ...provides age-appropriate, culturally sensitive care and maintains a safe environment. The RN educates patients and families, coordinates care across settings and among caregivers, and utilizes technology to plan and deliver care. A minimum of an Associate's Degree in Nursing...
- ...include coordinating daily operations, staffing, case flow, and management of inventory, instruments, supplies and equipment for... ...relationships and building rapport with physicians to ensure continued utilization of the specialty. Responsibilities also include functioning...Temporary workWork at officeShift work
- ...deliver patient-centered nursing care with a focus on cultural sensitivity and safety. The RN coordinates care across settings and teams, educates patients and families, and utilizes the nursing process to plan and evaluate care. Requirements include an Associate Degree...
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