Strategic RN: Utilization Review & Care Coordination
$73.86k - $96.02kSouth Miami Hospital
Baptist Health South Florida is seeking a qualified individual to conduct chart reviews for clinical financial resource utilization. The role requires effective communication with healthcare teams and various agencies to optimize patient outcomes. Qualifications include at least an Associates Degree in Nursing and 3 years of nursing experience, along with required certifications. The estimated salary for this position ranges from $73,860.80 to $96,019.04 per year. #J-18808-Ljbffr Baptist Health South Florida
$73.86k - $96.02k
...concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with the healthcare team for optimal... ...Licenses & Certifications: MCG Care Guidelines Specialist.... ...their non-leadership role as an RN. However, they are required to complete...SuggestedLocal area- ...is seeking a dedicated Utilization Management professional... ...licensure as either an LPN or RN and a minimum of 2 years... ...include reviewing patient clinical information, coordinating with healthcare teams, and... ...on teamwork and patient care. #J-18808-Ljbffr Itlearn...SuggestedFull time
$62.7k - $100.4k
A healthcare organization is seeking a Clinical Care Reviewer II responsible for processing medical necessity reviews and assisting with care coordination activities. Candidates need to hold an Associate's degree in nursing and have at least three years of clinical experience...Suggested$26.41 - $51.49 per hour
...California, MO is seeking a Clinical Member Services Reviewer. The role includes assessing clinical service... ...delivery. The ideal candidate has an active RN license and at least 2 years of experience in hospital or managed care settings. Competitive pay is offered, ranging...SuggestedHourly pay$71.1k - $97.8k
...insurance company is seeking a Utilization Management Registered Nurse to utilize... ...clinical nursing skills for coordinating medical services and benefit... ...clinical experience and a Compact RN license. Responsibilities include making care determinations, excellent communication...SuggestedRemote job- ...healthcare services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a current FL RN licensure and a minimum of 3 years of nursing... ...or ICU. Candidates should have experience with Utilization Review, familiarity with Interqual Criterion,...
- ...highest quality in‑home care services that improve... ...You Be Doing Concurrent review of patient’s clinical... ...for medical necessity Coordinates patient care needs with... ...updates to Manager of Utilization Management for review... ...licensure as a LPN or RN Minimum 2 years of prior...Full timeTemporary work
$62.7k - $100.4k
Job Summary Clinical Care Reviewer II is responsible for processing medical... ...health services) and care coordination for members, as well as... ...accredited registered nursing (RN) degree program required... ...health experience preferred Utilization Management/Utilization Review...Hourly payWork at office$65.58k - $108.65k
...Description Delivers safe care and demonstrates regard... ..., the Institutional Review Board, and the Office of Sponsored Programs. Coordinates the work of support staff... ...to maintain licensure. Utilizes positive interpersonal... ...Registered Nurse (RN) [Required] Basic Life...Full timeWork experience placementWork at officeLocal areaFlexible hoursShift work$26.41 - $51.49 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...Molina care model. Adheres to utilization management (UM) policies and procedures... ...experience. Registered Nurse (RN). License must be active and...Hourly payWork experience placementWork at officeRemote work$71.1k - $97.8k
Job Summary The Utilization Management Registered Nurse uses... ...and support the coordination, documentation and communication... ...manages post-acute care services, including Skilled... ...Registered Nurse (RN) license in your state... ...management/utilization review for a health plan or acute...Bi-weekly payTemporary workRemote work- ...staffing firm is seeking a Registered Nurse for Concurrent Review in Florida. The role involves telephonic review of... ...to ensure appropriate medical necessity and care levels. Candidates must have an active RN license in Florida and 2+ years of clinical experience...Full timeWork at officeMonday to Friday
$25k
The Clinical Care Nurse (RN) is a clinic-based nursing role focused on... ...(TOC), reduce avoidable ED utilization, and drive Medicare... ...transition support, follow-up coordination, and avoidable readmission... ...Clinical quality improvement and strategic gap closure. Transitions...Temporary workApprenticeshipWork at officeMonday to Friday$80k - $90k
...Responsibilities*** Performs clinical reviews on medical records to maintain... ...necessary.* Experience with utilization management systems or clinical... ...making tools such as Millimen Care Guidelines (MCG) or InterQual.... ...*** Active unrestricted RN license #J-18808-Ljbffr Performant...Remote workFlexible hours$61.86k - $96.66k
## RN, Care CoordinatorApplylocations: Tavares, FLtime type: Full timeposted on: Posted Todayjob requisition id: R261... ...responsible for assessing and identifying patient/family needs, utilizing the nursing process, coordinating the Plan of Care with the Interdisciplinary Team (IDT)...Local areaImmediate startNight shift- Background Screening Information - Position Summary The RN Unit Care Coordinator is responsible for supervising, implementing, coordinating, and managing patient care through interpersonal contact with patients, families, nursing staff, and others on his/her respective...
$33 - $39 per hour
.../hr The VITAS Telecare RN is a member of the interdisciplinary... ...and families by utilizing the nursing process, the VITAS Palliative Care Guide, and Telecare... ...with LPN/LVN’s. Coordinates all service delivery after... ...patient/family interaction. Reviews all entries in the...Contract workWeekend work- The MedElite Group is looking for a responsible LPN Care Coordinator in Hollywood, FL, to ensure the accuracy of patient records and collaborate with the team to provide high-quality care. This is a full-time in-office role that requires an LPN certificate and excellent...Hourly payFull timeWork at office
- ...management, discharge planning, care coordination and continuity, provider/... ..., as well as the ability to utilize both internal and external... ...Ensure Quality Measures are reviewed and addressed when applicable... ...corporate financial goals and strategic endeavors.CompetenciesTo...Work at officeWork from homeMonday to Friday3 days per week
- ...Healthcare Solutions is hiring a Supervisor, Clinical Review Nurse in New York. This full-time role involves overseeing Utilization Management activities and leading a clinical team. Candidates should possess an active RN license, a minimum of five years of clinical...Full time
- ...providing quality medical care and treatment that is coordinated and centered on the patient... ...Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the... ...nursing care as demonstrated by utilizing the nursing process...Relocation packageShift work
- ...Mercy Hospital - Registered Nurse (RN) - General Surgery, Nights (Saint,... ...: FULL_TIME Responsibilities: Utilize the nursing process to provide patient care. Maintain professional accountability... ...by other direct caregivers. Coordinate patient care in conjunction with other...Full timePart timeReliefFlexible hoursNight shift
$32.76 - $57.47 per hour
...disciplinary rounds to review changes in patient status... ...and level of care, and discharge plans for... ...to ensure timely care coordination and progression of care... ...Prior Care Management/Utilization Management experience (... ...Certifications: Registered Nurse (RN) (Required) Certified...Work experience placementReliefLocal areaFlexible hoursShift work- ...highest quality in-home care services that improve... ...You Be Doing As a Utilization Management Nurse, you... ...compliance. By continuously reviewing and auditing patient... ...for medical necessity Coordinates patient care needs... ...licensure as a LPN or RN Minimum 2 years of prior...Full timeTemporary work
- ...Registered Nurse- Hospice (Patient Care Coordinator)The Patient Care Coordinator... ...- Currently licensed as an RN in State of Florida. -... ...organizational decisions - Manages and reviews the budget for errors and... ...Performance Improvement and Utilization Review functions. #J-18808-...
- ...Nurse Clinical Competency Coordinator (2601235) Registered... ...of post-acute care. PruittHealth will help... ...procedures and attitudes and reviewing medical records and documentation... ...to facility partners utilizing the principles of Adult... ...an accredited/approved RN program. MINIMUM...
- ...accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note : Eligibility... ...Diem, Rotate Position Summary The Registered Nurse coordinates and provides safe care to patients utilizing the nursing process of assessment, planning,...Daily paidFlexible hours
- Wound Care Registered Nurse (RN) - $5,000 Sign on Bonus Valencia Hills Health and Rehabilitation Center... ...Care Specialist The Wound Care Nurse coordinates treatment to provide comprehensive... ..., genitourinary, and dermal systems. Utilizes current wound management theory when...Daily paidRelocation packageShift workNight shiftWeekend work
$85.2k
...YOU WILL DO: The Lead Medical Coordinator is an exempt position responsible... ...services for children in care. Additionally, the position is... ...medical information as necessary. Review and maintain current medical... ...: Licensed Registered Nurse (RN) with a Bachelor’s degree; Or...InternshipWork at officeLocal areaImmediate startFlexible hours- ...the highest degree of quality care is always maintained.... ...Assist in developing methods for coordinating nursing services with other resident... ...and emotional status Review the nurse's notes to ensure that... ...treatment areas daily, such as clean utility room, to ensure that they are...Local areaImmediate startTrial periodAll shiftsShift work
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