Utilization Review (RN) Part Time (28 hoursweek)
$44.7 per hourPart-time
Kittitas Valley Healthcare
The Utilization Review (UR) RN evaluates the medical necessity appropriateness and efficiency of healthcare services using MCG criteria ensuring compliance with CMS regulations and payer requirements. This role facilitates timely insurance pre-authorizations confirms medical necessity and helps prevent avoidable denials. The UR RN works closely with clinical teams case management and payers to support safe efficient care transitions and optimize reimbursement.
The UR RN also collaborates with the Revenue Cycle Director and finance teams to investigate denials inappropriate admission order status avoidable revenue loss and other financial risks. Responsibilities include monitoring length of stay and avoidable days and reporting trends and findings to the Utilization Review Committee to support regulatory compliance and continuous improvement in utilization practices.
Qualifications :
What is required...
- Graduate of an accredited nursing program with a current Washington State Registered Nurse (RN) license or Multistate License (MSL) with Washington endorsement (maintenance required)
- Minimum of 3 years of clinical nursing experience in acute care
- Experience with evidence-based care guidelines such as InterQual or MCG
- Familiarity with CMS Conditions of Participation commercial health insurance and managed care billing requirements
What is preferred...
- Bachelor of Science in Nursing (BSN)
- Experience working with Cerner EHR
- Knowledge of care guidelines from MCG
- Hospital case management experience
Additional Information :
Wage: Wage range currently starts at $44.70/hour and goes up to $79.60/hour. Actual wage will be based on years of applicable experience.
Shift Differentials apply; Evenings (3p-11p) $3.00/hour Nights (11p - 7a) 12% of hourly base rate Weekends $3.50/hour.
FTE: .7 (28 hours/week)
Benefits: This position is benefits eligible
Union Status: This is a WSNA union covered position
Remote Work :
No
Employment Type :
Part-time
Vacancy posted 7 days ago
Similar jobs that could be interesting for youBased on the Utilization Review (RN) Part Time (28 hoursweek) in Washington DC vacancy
$44.7 per hour
...The Utilization Review (UR) RN evaluates the medical necessity appropriateness and... ...requirements. This role facilitates timely insurance pre-authorizations... ...$3.50/hour. FTE: .7 (28 hours/week) Benefits:... ...Remote Work : No Employment Type : Part-time...Part timeHourly payRemote workShift workNight shiftWeekend workAfternoon shiftKittitas Valley Healthcare
Washington DC18 days ago$89.07k - $162.8k
About The Job Candidate must have acute care Utilization Review experience. Candidate must live in the DC/Baltimore region General Summary Of... ...leadership experience preferred Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure...SuggestedLive in- ...Overview Title: Clinical Review Nurse – Prior... ...Location: Fully Remote (PST Time Zone - WA/OR Resident)... ...Review to join our Utilization Management team. In this... ...Qualifications ~ Active RN license (WA; must be... ...Authorization role as part of our utilization management...SuggestedContract workRemote work
SPECTRAFORCE
Washington DC2 days ago - ...are seeking motivated and compassionate RN'S to join our team! The RN promotes and restores... .... Resolve resident problems and needs by utilizing multidisciplinary team strategies.... ...knowledge by attending educational workshops, reviewing professional publications, establishing...Part time
- ...team in identifying appropriate patients for care management review utilizing established care management criteria. Assesses plans and coordinates... .... When you join Virginia Mason Franciscan Health you become part of a team that delivers top-quality professional healthcare in...Part timeWork experience placement
Working at CommonSpirit Health
Washington DC2 days ago - ...Medical Center is now interviewing for a RN PRN Nursery! We provide exceptional care... ...to the appropriate care team members. Utilizes knowledge of human growth and development... ...staff. Participates in audits chart reviews and compliance checks to ensure adherence...Part timeRelief
Community Health Systems
Washington DC2 days ago $44.7 per hour
...hour. Actual wage will be based on years of applicable experience. FTE: .8 (32 hours/pay period) Benefits: This position is benefits eligible Union Status: This is a WSNA union covered position Remote Work : No Employment Type : Part-time...Part timeRemote workKittitas Valley Healthcare
Washington DC4 days ago- ..., recover, and recharge — one drip at a time. We're more than just a wellness bar. We... ...grow with us. Role Description The Part-Time RN — IV Hydration role involves providing safe... ...include assessing client health status, reviewing medical histories, obtaining informed...Part timeFull timeFlexible hours
Fitness Together - DC
Washington DC4 days ago - Description RN - Cancer Treatment Center @ Swedish First Hill Part time Variable Shift $10,000 Hiring Bonus for eligible external... ...and psychosocial information utilizing input from patient, significant... ...potential problems. Develops, reviews, and revises an individualized care...Part timeLocal areaShift work
$95k
...$95,000 USD per year Full-Time Requisition #: PICCR030815... ...maintaining aseptic technique utilizing measures that prevent patient... ...package to full time employees . Part time employees are eligible... ...For further information, please review the Know Your Rights notice...Part timeFull timeRelocation packageFlexible hoursTridentCare
Arlington, VA5 days ago- MedStar Health in the DC/Baltimore region seeks a Utilization Management Supervisor to lead the UR team, align daily workflow with physicians... ...patient care across the department. The role requires RN licensure, acute care UR experience, and leadership skills, with...
$77.31k - $115.98k
...Navigator/Complex Care Navigator RN or SW for our Care Navigation... ...psycho-social assessment and review of clinical needs of patients... .... Communicate with Utilization Review staff on any denials,... ...Employment Type: Variable Part-time Hours per Week: 4 - 8 hours...Part timeDaily paidLocal areaFlexible hoursShift workRotating shiftDay shift- ...life for all seniors. As a Wellness Nurse (RN), you oversee resident health, support... ...bigger impact than you ever imagined? As part of our team, you will help brighten the future... ...Assistant Program / Discount Program Paid time off (PTO), sick time, and holiday pay...Part timeShift work
- ...to those traveling overseas. Utilizing your experience and education,... ...professional development activities. As part of our team, you will receive... ...about federal benefits. Review our benefits Eligibility... ...whether your position is full-time, part-time or intermittent....Part timeFull timeOverseas
Central Intelligence Agency
Washington DC5 days ago $2,470 per week
...Minimum 2 years of experience required. COVID Vaccine - Required. Provide care for patients utilizing fetal and maternal monitoring equipment. Manage the patients pain including epidural and patient-controlled analgesia administration. Assist physician during delivery...Part timeNorthwest
Washington DC5 days ago$40.81 - $75.65 per hour
Registered Nurse (RN) Intensive Care Unit Job Type: FT | Days $10,000 - $20,000 Commitment-Incentive Bonus (Pro-Rated for Part-Time) Wage scale: $40.81 - $75.65 per hour This is a Union... ...contribute You'll make an impact by utilizing your specialized plan-of-care intervention...Part timeHourly payFull timeTemporary workImmediate startFlexible hoursShift workTrios Health
Washington DC14 hours ago- ...RN Clinical Educator Inova Alexandria Hospital... ...Balance: offering paid time off, paid parental leave... ...Job Responsibilities: Utilizes system strategies and tools... ...organization. Hours: Part-time, 20 hours/week (... ...completion date # Submit a review of transcripts from the...Part timeWork at officeMonday to FridayFlexible hours
$135k - $145k
...criteria for community in a timely manner. Oversees... ...monitoring, including review of physical exams, fall... ...team members accountable utilizing disciplinary procedures... ...Registered Nurse (RN) license in the Commonwealth... ...you work full-time, part-time, or PRN (as needed...Part timeFull timeReliefInternshipWork at officeLocal areaRelocation packageFlexible hoursShift workWeekend workGoodwin House
Alexandria, VAa month ago- ...team. This role offers full-time, part-time and PRN availability. Hours... ....Registered Nurse (RN) Case Manager 1 Job Responsibilities... ...case, excess days, resource utilization, readmission rates, denials and... ...and psychosocial needs through review of patient information,...Part timeFull timeReliefRemote workRelocation packageMonday to FridayFlexible hoursWeekend work
Inova Health System
Alexandria, VA2 days ago $43 - $46 per hour
...Part Time RN Opportunity Fairland Center is seeking a Part Time, 11pm-7am RN to join their team! We are dedicated to improving the... ...: Maintain accurate, real-time clinical documentation utilizing PointClickCare (PCC) EHR software. *Regulatory Compliance &...Part timeTemporary workImmediate startGeneis Healthcare
Silver Spring, MD4 days ago- ...Registered Nurse (RN) Full-time, Part-time & PRN Skilled Nursing Shift options & Shift Differentials Non-exempt, Essential Personnel... ...and notifies appropriate personnel of needs. Initiates, reviews and updates care plans as required. Promotes teamwork,...Part timeFull timeReliefLocal areaImmediate startShift work
Vierra Communities
Arlington, VA1 day ago $2,660 per week
...ongoing assessments including observation physical examination laboratory/test results and patient response to procedural intervention. Reviews and revises plan of care according to change in patients status. Incorporates patient teaching/discharge planning to promote...Part timeHCA Florida Largo Hospital
Largo, MD1 day ago$71 - $76 per hour
...Employment Type: Part time Shift: Description: Posting Are you an experienced... ...mobile staffing solution! FirstChoice RNs are utilized to fill short and long-term assignments... ...accredited school of nursing. Valid RN licensure authorized in the applicable state...Part timeHourly payDaily paidTemporary workLocal areaFlexible hoursShift workAfternoon shiftTrinity Health
Silver Spring, MD1 day ago$59 - $67 per hour
...Employment Type: Part time Shift: Description: Are you an experienced Registered... ...mobile staffing solution! FirstChoice RNs are utilized to fill short and long-term assignments... ...accredited school of nursing. Valid RN licensure authorized in the applicable...Part timeHourly payDaily paidTemporary workLocal areaImmediate startFlexible hoursShift workNight shiftTrinity Health
Silver Spring, MD1 day ago$43 - $62.07 per hour
...Washington, DC Position Type Available: Part Time Shifts Available: Day 7a-730p FT/PT Rate... ...employee referral program Annualperformance reviews andcompetitivebi-annualpay reviews... ...You’ll Be Doing: Our ICU Registered Nurse RN provide planning and delivery of direct and...Part timeHourly payDaily paidFull timeReliefLive outRelocation packageShift workHill Valley Healthcare
Washington DC4 days ago$40 - $56.78 per hour
...| Washington, DC Opening Type: Full-Time | Part-Time | PRN-Per Diem Shifts Available... ...referral program ~ Annual performance reviews and competitive bi-annual pay reviews... ...Here at BridgePoint the Registered Nurse RN provides planning and delivery of direct...Part timeHourly payDaily paidFull timeReliefLive outRelocation packageShift workNight shiftBridgePoint Healthcare
Washington DC3 days ago- ...Maxim Healthcare Services is seeking an RN or LPN to assume responsibility and accountability... ...Manager. Responsibilities Utilizes the nursing process to assess, plan,... ...Ventilator management Schedule: ~ Full-time ~ Part-time ~ PRN ~8, 10, or 12-hour shifts...Part timeWeekly payFull timeTemporary workReliefFlexible hoursShift work
Maxim Healthcare Service
Silver Spring, MD5 days ago - ...Evaluate and treat post-operative pain in a timely manner with appropriate intervention.... ...procedures for escalation of issues and utilize chain of command. Demonstrate proper use... ...enhance nursing practice. Engage in active review of peers giving constructive feedback...Part timeLocal area
- ...RN Supervisor Weekends Part Time: 7pm-7am Every Other Weekend Pay Negotiable Opportunities for Advancement REQUIRED: Prior Long Term Care... ...with the interdisciplinary team Documentation: Reviews and investigates incidents, transcribes orders, audits medical...Part timeDaily paidLocal areaWeekend work
Complete Care at Wall
University Park, MD5 days ago - ...Specialty Clinic Registered Nurse (RN) you will be a central figure in... ...Standards: Maintain accurate timely charting of patient progress and assessments while utilizing the nursing process to integrate... ...Franciscan Health you become part of a team that delivers top-quality...Part timeWork experience placement
Working at CommonSpirit Health
Washington DC4 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Review (RN) Part Time (28 hoursweek). Be the first to apply!
Related searches
- injection rn Washington DC
- pediatric icu rn Washington DC
- connect rn Washington DC
- pediatric oncology rn Washington DC
- davita rn Washington DC
- womens health rn Washington DC
- registered nurse ii Washington DC
- rn per diem nurse Washington DC
- hospice registered nurse Washington DC
- operating room rn Washington DC