RN Care Review Clinician - Utilization & Prior Auth
$26.41 - $61.79 per hourUloop
Uloop Inc. is looking for a Clinical Reviewer in Miami, Florida, to provide support for clinical member services review assessment processes. Responsibilities include assessing services, analyzing clinical requests, and ensuring compliance with guidelines. The ideal candidate will be a Registered Nurse with an active license and at least 2 years of relevant experience. The position offers a competitive hourly pay range between $26.41 and $61.79, depending on experience and location. #J-18808-Ljbffr
$26.41 - $51.49 per hour
...services for compliance and optimal outcomes, analyzing service requests, and collaborating with clinical teams. A valid Registered Nurse (RN) license is essential, alongside a minimum of 2 years in relevant healthcare settings. The position offers a competitive hourly pay...SuggestedHourly pay$26.41 - $61.79 per hour
...clinical member services review assessment processes.... ...integrated delivery of care across the continuum. Contributes... ...reviews to determine prior authorization/financial... ...care model. Adheres to utilization management (UM)... ...experience. Registered Nurse (RN) with an active and...SuggestedHourly payWork experience placementWork at office$26.41 - $51.49 per hour
...clinical member services review assessment processes.... ...integrated delivery of care across the continuum. Contributes... ...reviews to determine prior authorization/financial... ...care model. Adheres to utilization management (UM)... ...experience. Registered Nurse (RN). License must be...SuggestedHourly payWork experience placementWork at officeRemote work$29.05 - $67.97 per hour
...Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical... ...and appropriate level of care utilizing MCG/InterQual... ...of appeals for denied prior authorizations.... ...experience. Registered Nurse (RN). License must be active...SuggestedHourly payWork experience placementWork at office$29.05 - $67.97 per hour
...Description Job Summary Utilizing clinical knowledge and... ..., responsible for review of documentation to ensure... ...appropriate level of care utilizing MCG/InterQual... ...of appeals for denied prior authorizations. Includes... ...• Registered Nurse (RN). License must be active...SuggestedHourly payWork experience placementWork at office- ...seeking a Registered Nurse for clinical review in Miami, Florida. This role involves ensuring... ...nursing, including experience in utilization review. Skills in coding and regulatory compliance... ...package is offered, reflecting Molina's commitment to quality care. #J-18808-Ljbffr...
- ...faculty or staff position, please review this tip sheet. The... ...great opportunity for a Nurse Utilization Review Supervisor to work at UTower... ...will be available to assist Care Coordination staff when experiencing... ...Valid State of Florida RN license required Refer...Full timeTemporary workWorldwideNight shiftWeekend work
$33.92 - $58.15 per hour
...Nurse Reviewer I Virtual: This role enables associates... ...health approach to making care more integrated,... ...diagnostic imaging services by utilizing appropriate policies,... ...minimum of 1 year of prior utilization management,... .... Current unrestricted RN license in applicable state...Full timeWork experience placementWork at officeLocal area- ...Elevance Health is seeking a Medical Management Clinician Senior to manage complex cases and oversee clinical information... ...requires a minimum of 6 years of clinical or utilization review experience and active LPN/LVN or RN licensure. This role can be performed virtually,...Remote work
$25k
...Become a part of our caring community and help us put... ...The Clinical Care Nurse (RN) is a clinic-based... ...), reduce avoidable ED utilization, and drive Medicare Advantage... ...Cloud – per your prior employer’s population health... ...more than 30,000 clinicians who are committed to putting...Full timeTemporary workApprenticeshipWork at officeMonday to FridayFlexible hours- ...Join to apply for the Oncology Prior Authorization Case Manager, Non-RN - Remote role at University of Miami3... ...H8. Remote.Job SummaryUtilization Review Case Manager responsible for initial... ...retrospective chart reviews for clinical utilization and authorization for oncology...Full timeWork experience placementRemote work
- ...faculty or staff position, please review this tip sheet . The... ...opportunity for a full time Utilization Review Case Manager to work to... ...the patient. He/she monitors care and acts as a liaison between... ...review for services requiring prior authorization as well as timely...Full timeTemporary workWork experience placementRemote workWorldwide
- ...the planning and delivery of care utilizing nursing processes: assessment... ...with patients and families to review plan of care and solicits... ...CPI). Minimum Job Requirements RN Licensure within the State of... ...Intervention Program certification prior to the start of Clinical...Daily paidShift workNight shift
- ...Registered Nurse Field plans and delivers care to patients in their place of residence utilizing the nursing process of assessment... ...that consistently is updated and reviewed to reflect assessment findings to... ...plan development and implements prior to discharge of the patient....Interim roleWork at officeLocal areaWeekend work
- ...the planning and delivery of care utilizing nursing processes: assessment... ...Conducts handoff with oncoming RN utilizing SBAR; documents in... ...Standards and documents clinician notification in Cerner. Ensures... ...with patients and families to review plan of care, provide education...Full timeShift workNight shift
- ...CAN Community Health is seeking a Registered Nurse Clinician in Miami, FL. The RN will deliver comprehensive care using clinical judgment, assessing and planning care for patients impacted by infectious diseases. This full-time role offers generous benefits, including...Full time
$32 per hour
...Responsibilities: Utilizes the nursing process to... ...evaluate patient/client care and/or services provided... ...effectiveness of intervention Reviews plan of care and... ...Registered Nurse (RN) License for the state... ...BLS card. One year prior Registered Nurse (RN) experience...Hourly payWeekly payContract workTemporary work$34 per hour
...seeking a Registered Nurse (RN) Administrative for a... ...patient-family centered care in a culturally competent manner utilizing evidence-based standards... ...and physician orders. Reviews, evaluates and reports diagnostic... ...and messages for clinicians and nurse practitioners....Hourly payFull timeWorldwideShift work- ...Miami, FL. Description: The Utilization Management Nurse (RN or LPN) is responsible for coordinating... ...evaluating, and managing utilization review activities and authorization requests... ...with Medical Directors, Care Coordination teams, providers, and facilities...Full timeImmediate startMonday to Friday
$32 per hour
...RN Ventilator Care at Home Doral, Florida Hourly Pay: $32 / per hour... ...Responsibilities: Utilizes the nursing process to plan,... ...effectiveness of intervention Reviews plan of care and program protocols... ...BLS card. One year prior Registered Nurse (RN) experience...Hourly payWeekly payContract workTemporary work- ...the planning and delivery of care utilizing nursing processes: assessment... ...Conducts handoff with oncoming RN utilizing SBAR; documents in... ...30 minutes and documents a clinician notification in Cerner. Completes... ...patients and families to review plan of care and solicits input...Full timeNight shift
$27 - $32 per hour
...RN (Registered Nurse)- Homecare- Palmetto Palmetto... ...Responsibilities: Utilizes the nursing process to... ...patient/client care and/or services provided... ...effectiveness of intervention Reviews plan of care and... ...BLS card. One year prior Registered Nurse (RN) experience...Hourly payWeekly payContract workTemporary workFlexible hoursShift work- ...Brain Tumor/Oncology RN Navigator/Coordinator (Full... ...supervises individual patient care according to... ...indications following medical review. Arranges support groups... ...therapy. Utilizes Lean methodology to improve... ...stakeholders of practice schedule prior to clinic visit for...Full timeWork at office
- ...MDS Coordinator - RN A skilled nursing facility is looking... ...the Minimum Data Set (MDS), Care Area Assessments (CAA's) and... ...timely and accurate completion of Utilization Review and Triple Check. Serves... ...a long term care setting Prior experience as an MDS coordinator...
$33.92 - $58.15 per hour
...Elevance Health is seeking a Nurse Reviewer I to conduct medical necessity reviews and preauthorization for... ...Applicants must have an AS in nursing, a current RN license, and a background in clinical nursing or utilization management. Elevance Health provides a competitive...Remote work$1,611 - $3,032 per week
...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Miami, FL Agency... ...involves delivering patient-centered care, collaborating with interdisciplinary teams... ...the clock, any day, whenever they need us. Clinicians and travelers continue to work with our...Weekly payFull timeContract workImmediate startShift workNight shift$1,776 - $2,449 per week
...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Miami, FL Agency... ...involves delivering patient-centered care, collaborating with interdisciplinary teams... ...the clock, any day, whenever they need us. Clinicians and travelers continue to work with our...Weekly payFull timeContract workImmediate startShift workNight shift$2,088 - $3,180 per week
...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Miami, FL Agency... ...involves delivering patient-centered care, collaborating with interdisciplinary teams... ...the clock, any day, whenever they need us. Clinicians and travelers continue to work with our...Weekly payFull timeContract workImmediate startShift work$1,817 per week
...Registered Nurse (RN) | Emergency Room (ER) / Trauma Location: Miami, FL Agency... ...and your travel healthcare agency should care about you. Our team has lots of crazy ideas... ...of those recognitions are fueled by real reviews by real travel nurses and allied healthcare...Hourly payFull timeContract workWork at officeRemote workShift workNight shiftWeekend work$30.27 - $40.86 per hour
...are currently hiring experienced RN's who have recently worked in the Acute Care Setting: Cardiology Neurology... ...five areas of nursing practice utilizing critical thinking, management, problem... ...of urgency in the role of: clinician, teacher, researcher, leadership...Full timePart timeReliefCurrently hiringImmediate startRelocationShift workNight shift
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