Nurse Leader: Utilization Review & Care Coordination
Santa Barbara Cottage Hospital
Health Business Solutions (HBiz) is seeking a Manager, Utilization Review to lead a team of Utilization Review Nurses, oversee daily operations, and ensure efficient care coordination across hospital and outpatient settings. In this role you will monitor utilization and care plans, drive quality improvement initiatives, and collaborate with physicians, nurses, and social workers to optimize patient outcomes. #J-18808-Ljbffr Santa Barbara Cottage Hospital
$70k - $75k
Guidehealth seeks an experienced Utilization Management Registered Nurse to perform UR activities and document... ...standards. The role requires coordination with medical directors and providers... ...while ensuring timely, compliant reviews. Remote work option; salary range...SuggestedRemote job- ...Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely... ...2+ years in UM within managed care. Prior experience in various reviews...SuggestedRemote jobWork at office
- EmblemHealth is seeking a Clinical Reviewer in New York to perform... ...'s or Bachelor's degree in nursing, a valid RN license, and 4-... .... Responsibilities include coordinating care, communicating with... ...qualifications include certification in utilization management and strong...Suggested
- ...in Illinois is seeking an Illinois Licensed Utilization Management RN to work remotely full-time, coordinating patient care, ensuring cost-effective services, and verifying... ...medical necessity criteria during concurrent reviews and documentation. You will streamline...SuggestedRemote jobFull time
- ...golden thread” of compassionate care that connects staff and... ...Responsibilities As our Utilization Management Nurse, you will be a critical guardian... ...day, you will meticulously review medical records, authorize... ...stay reviews per the Care Coordination Utilization Review...Suggested
$18k
...focused on quality patient care and service to the community... ...communities we serve. Our doctors, nurses, and allied health... ...concurrent and retrospective utilization review to support and encourage the... ...continued stay reviews per the Care Coordination Utilization Review...Full timePart timeLive out$35 - $45 per hour
...poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources and services to meet patients’ needs... ...promotes collaboration across teams to optimize care, drive cost‑effective resource utilization, and...Contract workRemote workWeekend work- Currently seeking a Utilization Management RN . Please see details... ...active PA license or a Nurse Licensure Compact to... ...advanced clinical judgment to review medical records, validate care plans, and authorize... ...providers, support care coordination, ensure regulatory compliance...Immediate startRemote workWeekend workDay shift
$34 - $40 per hour
...to LPN's & RN's About the Role Medix is seeking an experienced Utilization Review Nurse to support our mission of improving patient care through home-based health services. In this role, you will coordinate and review patient authorizations, ensure compliance with Medicare...Full timeRemote work$35 - $43 per hour
...43.00/hr Job Title Clinical Review Nurse - Concurrent Review Location... ...Concurrent Review will perform utilization management functions to... ...ensure members receive the right care at the right time. This role... ...discharges to ensure timely coordination between care levels and...Remote work- ...Partners is seeking a licensed Practical Nurse (LPN/LVN) experienced in managed care UM to perform pre-service and post-service utilization reviews and appeals for DMEPOS, working with... ...and medical necessity criteria, coordinate with clinical and non-clinical staff,...Remote job
- ...Position Summary Concurrent Review Nurse is responsible for performing utilization management activities to ensure medical... ...necessity, appropriateness of care, and length of stay in accordance... ...staff, and insurance companies to coordinate patient care and discharge planning...ApprenticeshipLocal areaRemote work
- ...academic medical center in New York seeks a full-time Utilization Review & Quality Assurance Senior Coordinator / Utilization Review Nurse. The successful candidate will utilize clinical knowledge for patient care assessments and manage patient discharge planning. A Bachelor...Full time
- ...health services include home care, hospice and palliative care... ...children, rehabilitation and nursing care at Menorah, and the research... ..., primary responsibility to coordinate, implement and continually... ...care needs of your patients Review patient insurance information...Relocation package
$77.96k - $120.37k
...Barbara Cottage Hospital is seeking a Utilization Review Supervisor RN to direct operations within... .... This remote role requires a leader adept in managing a team, ensuring service... ...matters. The ideal candidate will have a nursing diploma, RN licensure, and at least three...Remote job$125k
...health services include home care, hospice and palliative care... ...children, rehabilitation and nursing care at Menorah, and the research... ..., primary responsibility to coordinate, implement and continually... ...your patients You will also review patient insurance information...Full timePart timeRelocation packageFlexible hours$75k
...Barbara Cottage Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires performing medical... ...hold an active RN license and have experience in acute care settings. The starting salary for this position is $75,0...Remote work- ...Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn)... ...Individual Patient Care On A Nursing Unit/Department... ...Service, Teamwork, Resource Utilization, And Staff And Self Development... ...Outlined In Performance Review. # Performs Other Duties...Temporary workFlexible hours
- ...is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and... ...using clinical guidelines and coordinate with providers and departments... ...independently in a fast-paced managed care environment. #J-18808-Ljbffr Santa...Remote job
- ...dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing... ...and outpatient utilization reviews while supporting transitions of care and ensuring patients receive... ...teams to ensure coordinated and effective care delivery....Remote work
- Santa Barbara Cottage Hospital is looking for a Utilization Review Clinician to ensure that medical necessities are reviewed effectively. This... ...with physicians and healthcare providers to manage patient care through established guidelines. The ideal candidate will possess...
$45 - $45.5 per hour
Overview Job Title: Nurse Case Management Senior Analyst... ...appropriate health care services in conjunction... ...physician treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate... ..., and retrospective reviews for inpatient acute care...Contract workImmediate startRemote workMonday to FridayAfternoon shift- ...A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare guidelines, and collaborating with...Remote work
$45k - $70k
...A healthcare services company is seeking a Utilization Management Nurse Reviewer to ensure medical services are used appropriately. The role involves reviewing medical records and coordinating care while adhering to guidelines. Candidates should possess an unrestricted...Remote work$41.41 per hour
...savings plans with healthcare and dependent care flexible spending accounts (FSA) and a... .... Participates in the formulation of nursing policies and goals as well as policies affecting... ...organization policies and procedures. Coordinates and supervises the delivery of nursing...Temporary workFlexible hoursShift workNight shiftWeekend workAfternoon shift- ...established industry player in healthcare is seeking a dedicated Utilization Review Nurse to join their team. This role involves conducting critical... ...to ensure efficient resource use and high-quality patient care. You will collaborate with clinical staff and stakeholders...
$26.01 - $74.78 per hour
...about transforming health care. As the nation's leading... ...opportunity for a full‑time Utilization Management (UM) Nurse Consultant. As a... ...utilize clinical skills to coordinate, document and communicate... ...around times. This includes reviewing written clinical records....Hourly payFull timeTemporary workWork at officeLocal areaFlexible hours- ...community hospital in Arizona is seeking a Utilization Management Nurse to ensure healthcare efficiency and quality through diligent review of medical records and adept communication... ...us in providing comprehensive patient care in a supportive environment. #J-18808-Ljbffr...
- ...? Then the PTC RN Coordinator Role is for you! This... ...comprehensive care coordination for patients... ..., medical/nursing staff procedures,... ...and continued stay, utilizing standard criteria.... ...other departments, leaders and presiding physicians... ...workshops, reviewing professional publications...Temporary workPart timeWork experience placementWork at officeLocal areaImmediate startFlexible hoursAfternoon shift
- A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...Remote jobContract work
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