Utilization Review RN - Improve Care & Cost Efficiency (20h)
Capital Health (US)
Capital Health System, Inc. seeks a Utilization Management professional to enhance patient care quality and efficiency. The role involves assessment of treatment plans, collaboration with healthcare teams, and ensuring compliance with regulatory guidelines. Candidates should have an Associate's degree in nursing, be a Registered Nurse in NJ, with a minimum of five years of clinical nursing and three years in quality management. Comprehensive benefits include medical, dental, vision plans, and retirement savings. #J-18808-Ljbffr
$135k
...respected community hospital in Brooklyn, is seeking a Utilization Review & Quality Improvement RN to join its clinical quality team. This position offers... ...the opportunity to make a meaningful impact on patient care through utilization review, quality improvement initiatives...SuggestedHourly pay- ...healthcare is seeking a dedicated Utilization Review Nurse to join their team. This... ...critical reviews to ensure efficient resource use and high-quality patient care. You will collaborate with clinical... ...healthcare regulations and improve patient satisfaction. The organization...Suggested
$26.41 - $61.79 per hour
...clinical member services review assessment... ...integrated delivery of care across the... ...provide quality and cost-effective member care... ...in a consistent and efficient manner. • Requests... ...model. • Adheres to utilization management (UM) policies... ...Registered Nurse (RN). License must be...SuggestedHourly payWork experience placementWork at office- ...of compassionate care that connects staff... ...Responsibilities As our Utilization Management Nurse,... ...of healthcare efficiency and quality,... ...will meticulously review medical records, authorize... ..., quality, and cost‑effectiveness, aligning... ...with facility RN Care Coordinators...Suggested
$30 - $38 per hour
...wellbeing solutions, and comprehensive care navigation together in one place.... ...data-driven solutions that reduce costs while actually improving health outcomes. Together, our... ...Responsibilities Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time...SuggestedHourly payFull timePart timeWork at officeRemote workMonday to FridayWeekend work$34 - $40 per hour
...Required) - Open to LPN's & RN's About the Role Medix... ...an experienced Utilization Review Nurse to support our mission of improving patient care through home-based health... ...deliver high-quality, cost-effective care. What... ...services, and support efficient use of healthcare resources...Full timeRemote work- ...for licensure as an RN in the Commonwealth... ...Interqual Level of Care Criteria, MCG, or... ...admission and admission review for Medicare and... ...appropriate utilization of resources. Promotes... ...influence high‑quality and cost‑effective care.... ...‑time coaching to improve outcomes....Full timeWork experience placementWork at officeLocal areaImmediate startNight shift
- ...Utilization Management, Registered Nurse (RN) Remote - USA At Clover Health,... ...prioritize preventive care while leveraging... ...care at a lower cost—delivering the... ...are smooth, efficient, and always focused on improving member outcomes... ...medical necessity reviews for prior authorization...Work at officeRemote workFlexible hours
$35 - $43 per hour
...Job Title Clinical Review Nurse – Concurrent... ...hold an active CA RN license) Duration:... ...will perform utilization management functions... ...receive the right care at the right time.... ...ensure appropriate and cost-effective care.... ...recommendations for process improvement. Provide subject...Remote work- ...RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the... ...THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare... ...promote high quality and cost effective health care... ...Quality and Performance Improvement Initiatives. Timely follow...Full timeLocal areaWork from home
$35 - $45 per hour
...IntePros is seeking a Remote Utilization Review Nurse serves as a key... ...collaboration across teams to optimize care, drive cost‑effective resource... ...coordinate services, and ensure efficient use of healthcare resources... ...nursing program (RN, LPN, or LVN). Minimum of two...Contract workRemote workWeekend work- ...MVP Health Care is seeking a Sub-Acute RN UM Reviewer-Medicare to join our Utilization Management team. In this remote role, you will conduct clinical reviews to ensure... ...experience in sub-acute care. Join us to contribute to improving healthcare delivery and be part of a team that...Remote work
- ...specific plan of care for designated group... ...others, reviews patient's chart and... ...; coordinates the cost-effective use of supplies... ...safely, timely and efficiently; makes accurate observations... ...for performance improvement; designs,... ...agencies; recognizes and utilizes health teaching...Hourly payLocal area
$68k - $115k
...specific plan of care for designated group... ...others, reviews patient's chart and... ...; coordinates the cost-effective use of supplies... ...safely, timely and efficiently; makes accurate observations... ...for performance improvement; designs,... ...agencies; recognizes and utilizes health teaching...Hourly payLocal area- ...specific plan of care for designated group... ...others, reviews patient's chart and... ...; coordinates the cost-effective use of supplies... ...safely, timely and efficiently; makes accurate observations... ...for performance improvement; designs,... ...agencies; recognizes and utilizes health teaching...Hourly payLocal area
$70k - $100k
...Utilization Management RN - Behavioral Health (OR Licensed) Position... ...etc.) Perform 15-30 reviews per day Performs initial... ...of managed care: Patient Education, Wellness... ...members to manage and improve their health, wellness... ...appropriate, cost-effective solutions Identify...Minimum wageWork at officeMonday to Friday- ...coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and... ...May oversee work delegated to Central Utilization Review LVN/LPN Case Manager and/or Central Utilization Authorization...Work at officeRemote work
- ...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
$75k
...Registered Nurse to perform inpatient utilization reviews, ensure compliance with medical necessity... ...engage with healthcare teams to improve patient outcomes. This role requires a current RN license, two years of acute care experience, and familiarity with InterQual...Remote workFlexible hours$18k
...Center has focused on quality patient care and service to the community. As... ...concurrent and retrospective utilization review to support and encourage the efficient and effective use of resources; promote... .... Collaborates with facility RN Care Coordinators to ensure progression...Full timePart timeLive out$45k - $70k
...healthcare company in the United States is looking for a Utilization Management Nurse Reviewer to ensure the efficient use of medical services and provide clinical expertise. Applicants must have an active LVN/RN license, with a preference for candidates having a minimum...Remote work- ...Currently seeking a Utilization Management RN . Please see details and qualifications... ...through medical record review to determine medical necessity... ...physicians to ensure appropriate care settings. Report utilization trends and recommend improvements. Ensure requests align with...Immediate startRemote workDay shift
- ...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...
- Village Center for Care, Inc. is seeking a self-motivated RN for the role of Utilization Review Nurse in a full-time, hybrid position located in the New York Tri-State Area. The successful candidate will be responsible for assessing member needs and ensuring high-quality...Remote jobFull time
$2,417 per week
...Registered Nurse (RN) | Long-Term Care Location: New... ..., Medication Review, Discharge Wrap Up... ...Practices safe and efficient patient-centered... ...opportunities for improvement.2. Demonstrates clinical... ...protocol.9. Utilizes institutional... ...patient focused and cost effective...Hourly payDaily paidPermanent employmentFull timeContract workTemporary workLocal areaShift work- ...States is hiring for a Concurrent Review Nurse responsible for performing utilization management activities remotely.... ...professionals to ensure appropriate patient care. The ideal candidate will be a... ...regulatory standards and quality improvement initiatives. #J-18808-Ljbffr...Remote work
$50 per hour
...experienced Registered Nurse Clinical Reviewer for a fully remote position with... .... This role involves conducting utilization reviews and ensuring healthcare... ...have an active New York State RN license and 1-3 years of experience in acute care utilization review. Competitive...Remote jobHourly pay$52 - $90 per hour
...specific plan of care for a designated group... ...others, reviews patient's chart and... ...Coordinates the cost-effective use of supplies... ...safely, timely and efficiently; Makes accurate... ...data for performance improvement; Designs,... ...# Recognizes and utilizes health teaching opportunities...Hourly payFull timeLocal area- ...specific plan of care for designated group... ...others, reviews patient's chart and... ...; coordinates the cost-effective use of supplies... ...safely, timely and efficiently; makes accurate observations... ...for performance improvement; designs,... ...agencies; recognizes and utilizes health teaching...Hourly payLocal area
- ...specific plan of care for a designated group... ...others, reviews patient's chart and... .... Coordinates the cost-effective use of supplies... ..., timely and efficiently. Makes accurate observations... ...for performance improvement. Designs,... ...agencies. Recognizes and utilizes health teaching...Hourly payLocal area
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