Utilization Review Nurse (RN)
Universal Hospital Services Inc.
Responsibilities Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse, RN to add to our growing team. Lighthouse Care Center of Augusta Lighthouse Care Center of Augusta (LCCA) is a multi-discipline behavioral healthcare center that offers mental health services to the communities of surrounding Augusta, Georgia. The Lighthouse Care Center of Augusta is an acute and residential treatment facility providing balanced, top-notch clinical care to children, adolescents and young adults. We provide a carefully-structured and supportive environment, and our education program is accredited through the Georgia Accrediting Commission. Utilization Review Nurse, RN Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: Review clinical content of medical records Participate in treatment team meetings Collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved Utilization Review/Business Office Coordinator will ensure input of pre-certifications and continued stay reviews into Midas Follow-up on unfinished pre-certifications from the day before Coordinate with the treatment team on any follow-ups necessary Verify insurance coverage at the first of the month, and post patient payments into MS4 Trained in all aspects relative to timely gathering clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems Additional job duties Benefit Highlights: Referral Bonus Program Challenging and rewarding work environment Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan SoFi Student Loan Refinancing Program Career development opportunities within UHS and its 300+ Subsidiaries Pet Insurance More information is available on our Benefits Guest Website: uhsguest.com About Universal Health Services: Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. Qualifications Education and Experience: Registered Nurse (RN) preferred or License Professional Nurse (LPN) Current GA or Multistate Valid RN or LPN license Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review EEO Statement: All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Universal Hospital Services Inc.
$88.85k
...income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically...SuggestedFull time- Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care... ...weekend hours are required to address utilization review cases. Roles and Responsibilities... ...Must have a current, unrestricted Texas nursing license or Compact License. Please include...SuggestedLive inRemote workFlexible hoursWeekday work
- The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and... ...Current Nursing licensure in the state of operation required;RN is required unless local state regulations permit LVN/LPN 4...SuggestedMinimum wageWork at officeLocal areaRemote workFlexible hours
- Work Shift The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of... ...discharge and provide the physician and nursing staff with the best possible options... ...Registration/Licensure: Current US state RN license with authorization to practice...SuggestedWork at officeShift work
$47.85 - $67.04 per hour
...Job Title: RN Location: Jersey City Medical Center Department Name: Medical-Surgical Unit-I Req #: 0000248983 Status: Hourly... ...: Required: Graduate from an accredited School of Nursing Bachelor’s degree in nursing Preferred: ~ Excellent verbal...SuggestedHourly payPart timeWork experience placementLocal areaFlexible hoursShift workNight shiftWeekend work- ...Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is responsible for utilization... ...) Keywords Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management,...Temporary workRemote workShift work
$47.85 - $60.6 per hour
...Job Title: RN 12.5 Specialty Float Tele Location: Cooperman Barnabas Medical Ctr... ...graduate ability to transition into a competent nurse. Qualifications: Required: Must... ...patient education and provides education utilizing appropriate educational modalities...Hourly payFull timeWork experience placementLocal areaFlexible hoursShift workWeekend work- ...follow up needs. Follows NYS Standards for Professional Registered Nurse. Graduate from an accredited School of Nursing. At least two... ...Community Health, Hospice or Oncology nursing preferred. New York State RN licensure, NYS valid drivers license preferred. Will sit for the...Relocation packageShift work
- ...recommendations based on each patient's needs. Assessments may take place in private homes, hospitals or nursing facilities. As a Hospice Field Admission Nurse (RN) , you will admit eligible patients onto the Hospice program following the appropriate standards of practice...Full timePart timeRelocation packageFlexible hours
- ...for adults and children, rehabilitation and nursing care at Menorah, and the research based... ...care needs of your patients. You will also review patient insurance information, coordinate... ...interact with an integrated team Current NYS RN license and registration Bachelor’s...Relocation package
$90k - $107k
...Mass General Brigham Health Plan Holding Company, Inc. is seeking a Remote UM Nurse to support network adequacy review and authorization activities for members in ACO, HMO, and EPO products. The role requires clinical knowledge to review prior authorization requests,...Remote work- ...Health Agency to hire experienced Registered Nurses (RNs) with UAS Assessment experience for... ...comprehensive in-home assessments utilizing the UAS-NY system to evaluate patient needs... ...Active New York State Registered Nurse (RN) License Current UAS-NY Certification...Full timeRemote workMonday to FridayFlexible hoursWeekday work
- ## Utilization Review NurseApplyremote type: Hybridlocations: 1301 6th Ave W - BRADENTON, FLposted on: Posted Todayjob requisition id: JR1141... ...possible.**Job summary:**Acrisure is seeking a **Utilization Review Nurse, LPN** to evaluate treatment requests and help ensure injured...Work at officeImmediate startRemote workFlexible hours2 days per week
$47.85 - $64.04 per hour
...Job Title: RN Location: Newark Beth Israel Medical Ctr Department Name: Operating... ...Qualifications: Required: ASN or Nursing Diploma Strong communication and organizational... ...care team by communication with and utilizing resource persons and programs available....Hourly payFull timeWork experience placementLocal areaMonday to FridayFlexible hoursShift workWeekend workDay shift$85.28k - $89.44k
...Registered Nurse (RN) Pediatric Home Health Sign-On Bonus Opportunity! Eligible candidates may qualify for a $500sign-on bonus* as part of their total compensation package. Bonus eligibility and payout structure will be discussed early in the interview process....Weekly payLocal areaRelocation packageFlexible hoursShift work$35 - $45 per hour
...Sign-On Bonus Up to $2,500.00 If you want to be appreciated, come to BAYADA: BAYADA Home Health Care is looking for a Registered Nurse (RN) who has a passion for Adult and/or Pediatric care to join our Hudson County team. We believe our clients and their families deserve...Weekly payDaily paidFull timePart timeReliefWork at officeLocal areaRelocation packageFlexible hoursShift workDay shift- ...Careers Advancement Job Summary We are seeking a Registered Nurse to join our team. In this role, you will primarily be creating... ...plan of care for individual patients. You are a Registered Nurse (RN) who operates with great attention to detail and a big heart. You...Flexible hours
- ...Job Description Job Description Join a Company That Puts People First! Registered Nurse – RN We are one of the largest private duty nursing companies in the nation and growing! At Aveanna, we’re proud to foster a workplace culture that celebrates diversity, encourages...Weekly payDaily paidFull timePart timeFor contractorsReliefLocal areaFlexible hoursShift workNight shiftWeekend workDay shift
- ...Responsibilities Emergency Room RNs (ER RNs) record present symptomology, as well as collect a thorough patient history. The ER RN assesses, plans, implements, and evaluates patient care plans in coordination with other healthcare team members. ER RN job responsibilities...Local areaShift workNight shift
- CorVel Corporation is seeking a Utilization Review Nurse to gather demographic and clinical information for prospective, concurrent, and retrospective reviews of in-patient admissions and outpatient treatment, certifying medical necessity and assigning length of stay in...Remote job
- SUMMARY The Authorization Nurse will oversee the processing of assigned authorizations for participant care, supplies, and other related... ...' experience in a managed care environment, preferably in a utilization related role. Must have one year of experience with a frail,...Work at office
$77.08k - $119.47k
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted on: Posted Todayjob requisition... ...and health care team.**Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate's degree required...Shift work- ...Description Responsibilities Emergency Room RNs (ER RNs) record present symptomology, as well as collect a thorough patient history. The ER RN assesses, plans, implements, and evaluates patient care plans in coordination with other healthcare team members. ER RN job...Local areaShift work
$85.28k - $89.44k
...Registered Nurse (RN) Pediatric Home Health Sign-On Bonus Opportunity! Eligible candidates may qualify for a $500sign-on bonus* as part of their total compensation package. Bonus eligibility and payout structure will be discussed early in the interview process....Weekly payLocal areaRelocation packageFlexible hoursShift work- ...Job Description Job Description Responsibilities Stepdown Nurses (RN) provide patient care in transitional units where patients are too sick for the med-surg floor but not sick enough for intensive care. Stepdown RNs job responsibilities include, but are not limited...Local areaShift workNight shift
- ...truly matter? We’re looking for passionate Telemetry Registered Nurses who thrive in fast‐paced hospital environments and love being at... ...in the medical record What We’re Looking For Active RN license in the state of practice Previous experience as a Telemetry...Daily paidShift work
- ...other disciplines including Care Manager, Assessment Nurse and Primary Care Physician or other Specialists as... ...program, Bachelor’s preferred Knowledge with Utilization management processes preferred Current NY RN license and registration required CCM preferred...Relocation package
- Tele Rn Position Tele Rn Position Available Shift Details: Week 1: 07:00 AM - 07:30 PM Week 2: 07:00 AM - 07:30 PM Job Order Details: Start Date: 09/14/2026 End Date: 01/04/2027 Duration: 16 Week(s) Client Details: State: NYShift work
- ...RN - CVOR About the Position Specialty: RN – CVOR Experience: 2+ years of recent CVOR or Cardiac Surgery experience License: Active State or Compact RN License Certifications: BLS, ACLS – AHA Must-Have: Proficiency in circulating cardiac surgical procedures; scrub...
- ...RN - Tele Profession: Registered Nurse Specialty: Telemetry Duration: 13 weeks Shift: Day Hours per Shift: 12 Experience: Minimum 1 year of current... ...CABG patients is preferred but not required.The equipment utilized in this unit includes a GE Telemetry system and the EMR...Shift workDay shift
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