RN Supervisor - Clinical Review & Utilization
COMAGINE HEALTH
COMAGINE HEALTH is seeking a Supervisor, Clinical Review based in Alabama. This role requires an active RN license and involves the supervision of clinical staff conducting utilization reviews. A successful candidate will have at least 3 years of clinical experience, 1 year in a supervisory role, and knowledge of medical management processes. The company offers a supportive work environment focused on improving healthcare delivery and patient outcomes. #J-18808-Ljbffr COMAGINE HEALTH
$52.26 - $81.13 per hour
...Description The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing...SuggestedDaily paidMinimum wageLocal areaShift work- Providence Swedish Medical Center in Seattle is seeking a Utilization Review Nurse with a strong clinical background and skills in Utilization Management. The... .... A Bachelor's Degree in Nursing and a Washington RN license are required, along with three years of clinical...Suggested
- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...SuggestedRemote jobFull time
$52.26 - $81.13 per hour
Description The Utilization Review (UR) Nurse has a strong clinical background blended with a well‑developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and...SuggestedDaily paidShift work- ...and Territorial Epidemiologists is looking for a Clinical Review Supervisor to oversee clinical staff conducting utilization reviews. This fully remote position requires... ...development. Qualifications require an active RN license, a minimum of 5 years of clinical experience...SuggestedRemote job
- ...Role This role requires that the employee is an active RN and based in Alabama. The Supervisor, Clinical Review plays a critical role in providing operational supervision of clinical staff who conduct utilization review and/or specialty reviews. The Clinical Review supervisor...Contract workRemote work
- ...healthcare organization is seeking a Care Manager RN for a remote role primarily serving the... ...This per diem position involves crucial utilization management activities, ensuring... ...Washington RN license along with 3 years of clinical experience. The role offers competitive hourly...Remote jobHourly payDaily paidDay shift
$29.05 - $67.97 per hour
Molina Healthcare in Bellevue, Washington, is looking for a Registered Nurse (RN) with at least 2 years of clinical nursing experience. You will utilize your clinical knowledge to review documentation for medical necessity and appropriate levels of care. The position involves...Hourly pay- ...and oversees the team focusing on utilization management inpatient medical necessity reviews and transitions of care (TOC)... ...part in driving performance across clinical quality, timeliness, and care coordination... ...Hold a current, unrestricted RN license in the State of...Full timeTemporary workPart timeWork experience placementWork at officeTrial periodFlexible hours
$41.38 - $69.02 per hour
...RN Utilization Management Nurse (InPatient) – California HMO Virtual: This role enables... ...for California HMO is responsible for review of the most complex or challenging cases... ...thinking, and holistic assessment of member’s clinical presentation to determine whether to...Full timeTemporary workWork experience placementWork at officeLocal areaShift work1 day per week$29.05 - $67.97 per hour
Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG... ...education and experience. Registered Nurse (RN). License must be active and unrestricted in state...Hourly payWork experience placementWork at office- ...in an environment that allows you to thrive both personally and professionally. Position Overview We are seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess the medical necessity and quality of healthcare services through prospective, concurrent...Full timeContract workRemote work
- Dialysis Clinical Manager - Registered Nurse - RN page is loaded## Dialysis Clinical Manager - Registered Nurse... ...completion of the Annual Standing Order Review and Internal Classification of... ...clinic financials including efficient utilization of supplies or equipment and...Hourly payWork experience placementWorldwide
- ...patients and health services to be rendered. Develops, evaluates, reviews, revises, and implements policies and procedures; goals and... ...treatment, assuring case conferences are conducted, reviewing clinical and progress notes, periodic patient evaluations, and determining...
$110k - $125k
RN Clinical Manager - Home Healthcare (Full‑time, days) Associate or bachelor's degree in nursing. Current RN license, specific to the... ...and aides. Organizes clinical operations for the care center. Reviews requests for services and determines patient eligibility/...Full timeImmediate startRelocation packageShift work$145k - $160k
...exciting and rewarding opportunity for a RN Hospice Executive Director to join our leadership... ...in hospice care, home health, or clinical operations management. If you’re a natural... ...goals and standards for performance; reviews and monitors progress regularly and redirects...Daily paidFull timeContract workTemporary workPart timeInterim roleWork at officeLocal areaImmediate start$217.6k - $294.4k
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE Hybrid... ...Directors provides leadership, and clinical oversight for behavioral health... ...strategies related to our members. Conducts case reviews requiring physician involvement and/or...Part timeWork at officeImmediate startWork from homeRelocationFlexible hours3 days per week$100k
...than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and... ...Practical Nurses (LPN) and Registered Nurses (RN). • Prepare recommendations for hiring and termination for review and approval by the Home Health Administrator...Full timeWeekend work$90k - $100k
...Pediatric RN Clinical Case Manager Duties and Responsibilities Ensures supervision... ...pertinent information to the Clinical Supervisor/Director of Clinical Services. Ensures... ...policies and State regulations. Reviews clinical documentation to ensure it is...Temporary workWork at officeFlexible hours$47.64 - $88.19 per hour
...Clinical Nurse Coordinator Fred Hutchinson Cancer Center is an independent, nonprofit organization... ...of the Registered Nurses (RN), the Clinical Nurse Coordinator (CNC) will... ...resources Prescription refills Result reviews Indirect Patient Care Supportive...Hourly payH1bVisa sponsorshipRelocation packageFlexible hoursShift work$44.3 per hour
...90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social,... ...and flu vaccine organization Home Health RN Clinical Manager - Posting #25578 Hourly... ...recommendations for hiring and termination for review and approval by the Home Health...Hourly payFull timeWork at officeWeekend work- COMAGINE HEALTH is seeking a registered nurse for Clinical Review and QIDP responsibilities, working remotely from any U.S. location. The role requires an active RN license in Alabama, a BA/BS in Nursing, and at least three years of direct patient care experience. Responsibilities...Remote jobWork from home
$190k - $235k
...engineering, identifying issues and applying suitable solutions. Review construction plans, design calculations, specifications, cost... .... Enforce compliance with company expectations for staff utilization and implement corrective action plans when necessary. Resolve...Full timeCasual workWork at officeLocal areaRemote workFlexible hours- Cambia Health Solutions is seeking a Supervisor Utilization Management to lead a team dedicated to improving health care delivery. This hybrid role requires leadership skills and clinical expertise to ensure quality care through effective utilization management programs...
$119.58k - $149.47k
...Reporting to the Vice President of Clinical Services, this role is... ...across behavioral health programs, utilizing operational data, performance indicators, and collaborative review processes to strengthen... ...LMHC, LMFT, LICSW, Psychologist, RN, ARNP, SLP, BCBA, OT, or other...Flexible hours- An established industry player in home health care is seeking a dedicated Patient Care Coordinator to oversee patient assignments and ensure quality care delivery. This role involves coordinating patient services, managing staff, and developing policies that align with ...
$62.9 - $99.31 per hour
...Description The Clinical Program Manager, RN is responsible for using the evidence, technology, and internal and external constituent feedback, to evaluate, plan, develop, operationalize future department and organizational needs, and evaluate a wide variety of clinical...Minimum wageFull timeLocal areaShift work- Swedish in Seattle is looking for a Clinical Supervisor RN to manage clinical workflows and staff within the clinic. This role is crucial for ensuring efficient, safe, and high-quality patient care, aligning nursing practices with clinic standards. The ideal candidate...
$107k - $145k
...care settings, from the hospital to the clinic to the home, the Tablo® Hemodialysis System... ...and executes regular customer business reviews (CBRs) for all assigned accounts to... ...workflow efficiency improvement to drive utilization. Reviews, revises, and refines programmatic...Local areaRemote work- ...Leads, develops, directs and implements clinical and non-clinical activities that impact... ...conduct peer clinical and/or appeal case reviews and peer to peer clinical reviews with attending... ...of the United States when conducting utilization review or an appeals consideration and...
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