Inpatient Utilization & Care Coordination RN
EmblemHealth
EmblemHealth is seeking a Clinical Reviewer in New York to perform clinical reviews and ensure accurate administration of benefits. The ideal candidate must have an Associate's or Bachelor's degree in nursing, a valid RN license, and 4-6 years of nursing experience. Responsibilities include coordinating care, communicating with providers, and preparing clinical case summaries. Preferred qualifications include certification in utilization management and strong communication skills. This role is essential for maintaining care standards and facilitating patient care within the benefit plan. #J-18808-Ljbffr EmblemHealth
- ...seeking an experienced Registered Nurse to join their team in New York. The role involves providing quality, cost-effective care by evaluating inpatient, outpatient, and specialty service requests. Candidates should have a minimum of three years of medical/surgical nursing...Suggested
- The Carle Foundation 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...SuggestedRemote jobFull time
$105k - $122k
...Assistance + Pension AND 403(b) + Free RN-to-BSN/MSN Programs + Flexible... ...providing hospice, palliative care, and advanced illness services... ...team as a Hospice Clinical Coordinator RN. This role partners... ...admissions, provide inpatient hospice support, and ensure patients...SuggestedLocal areaRelocation packageFlexible hoursShift work$85.7k - $128.54k
## Utilization Management Nurse, Lead (Inpatient | Remote | Must have California LVN / RN License)Applyremote type: Fully Remotelocations: Anywhere in the U.S.time type: Full... ...is breaking the mold in conventional health care, committed to serving seniors and those who...SuggestedRemote jobImmediate startMonday to Friday$45 - $45.5 per hour
...evaluates appropriate health care services in conjunction... ...treatment plan. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options... ...reviews for inpatient acute care, rehabilitation... ...more junior team members. RN and current unrestricted...SuggestedContract workImmediate startRemote workMonday to FridayAfternoon shift$40 - $45 per hour
...Immediate need for a talented RN Care Management Coordinator . This is a 03 months Contract opportunity... ...advanced medical knowledge to cases, utilizing specified resources and guidelines... ...Medical Policy to establish the need for inpatient, continued stay, length of stay,...Contract workLocal areaImmediate startRemote work- ...seeking a skilled Registered Nurse to ensure high-quality patient care while managing medical resources efficiently. This role... ...significant acute hospital experience, including two years of utilization review experience. Adventist Health champions the wellbeing of...
- Memorial Sloan Kettering Cancer Center is seeking a Case Manager to coordinate care for Oncology patients. Responsibilities include clinical assessments, managing appeals with insurance, and ensuring continuity of care. Ideal candidates have a BSN and at least 2-3 years...
- Job Description RN/Case Manager (Inpatient)-Mount Sinai Morningside FT Days The... ...development of the plan of care; ensure that the plan is... ...efficiency, quality and resource utilization. Assignment will be by... .... Implementation and coordination of specific activities, strategies...Hourly payTraineeshipWeekend workWeekday work
- 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...
- Molina Healthcare seeks a Telephonic Care Review Clinician (RN) to support Medicare inpatient utilization management. You will verify medical necessity, review admissions... ...with providers, case management, and care coordination to ensure appropriate, cost-effective care. The...Remote jobMonday to FridayFlexible hours
- ...Acute Inpatient Registered Nurse - RNSkip to main contentFresenius Medical Care AG uses necessary cookies on this career website to enable... ...Inpatient Registered Nurse - RN page is loaded## Acute... ...responsible for the provision and coordination of clinically competent care including...Hourly payWork experience placementImmediate startNight shiftWeekend work
$37.18 - $49.92 per hour
...Registered Nurse I Department: Inpatient Surgical Unit Location: Rochester... ...SUMMARY As a Registered Nurse (RN), you’re the engine and the heart of patient care at Rochester Regional Health. You... ...ongoing assessment of the patient, utilizing appropriate data (i.e. physical,...Part timeLocal areaNight shift- ...required, we will train! Great for RN’s with prior acute experience such... ...The professional registered nurse Inpatient RN CAP 2 may be an entry level designation... ...responsible for the provision and coordination of clinically competent care including assessment, planning,...Daily paidFull timePart timeShift workNight shiftRotating shiftWeekend work
- ...creating a national model for improving health. The RN Performance Improvement Coordinator evaluates the quality of health care rendered by the System for the purpose of meeting regulatory requirements for inpatient and outpatient assigned areas. Responsibilities Evaluates...Temporary workShift work
- ...Staff Development Coordinator (Registered Nurse/RN) Life Care Center of Columbia SC Employment Status: Full-Time Shift: Days Position Summary The RN Staff Development Coordinator plans, organizes, develops, and directs all in service education in accordance with all applicable...Full timeShift work
$75k
...Hospital is seeking a dedicated Registered Nurse for inpatient utilization review responsibilities. This role requires... ...informed decisions. Candidates must hold an active RN license and have experience in acute care settings. The starting salary for this position is...Remote work- ...Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, Implements,... ...And Supervises Individual Patient Care On A Nursing Unit/Department According... ...Service, Teamwork, Resource Utilization, And Staff And Self Development As...Temporary workFlexible hours
- ...golden thread” of compassionate care that connects staff and... ...and Responsibilities As our Utilization Management Nurse, you will be... ...continued stay reviews per the Care Coordination Utilization Review guidelines... ...Collaborates with facility RN Care Coordinators to ensure...
$33 - $55 per hour
CH01 CHE Fresenius Medical Care (Schweiz) AG is looking for an Acute Inpatient Registered Nurse (RN) in Cape May Court House, NJ. In this role, you will deliver and coordinate effective patient care, particularly for those with kidney disease, ensuring adherence to health...Hourly payFull time$101.5k - $120k
Hospital Inpatient Clinical Care RN with $15K Sign on Bonus $101,500 - $120,000 per year | New York, NY | On‑Site | Permanent Hospital Clinical... ...families to ensure clear and effective communication and coordination of hospice care, including business development. Conduct...Permanent employmentFull timeTemporary workLocal areaRelocation packageMonday to FridayFlexible hoursShift work- ...practical nurse to join BHPS Utilization Management as a remote reviewer... ...clinical guidelines and coordinate with providers and departments... ...role requires reviewing both inpatient and outpatient services, familiarity... ...in a fast-paced managed care environment. #J-18808-Ljbffr...Remote job
- ...Registered Nurse to provide direct care in the Child & Adolescent... ...possess at least 1-2 years of inpatient pediatric and/or psychiatric nursing... .... Responsibilities include utilizing trauma-informed care and... ...performance improvement. A valid NY RN license is required, and BLS...
- ...dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing... ..., you’ll perform both inpatient and outpatient utilization... ...transitions of care and ensuring patients receive... ...interdisciplinary teams to ensure coordinated and effective care...Remote work
$41.41 per hour
Geisinger is seeking an Inpatient Registered Nurse for night shifts at the Geisinger Wyoming... ...involves assessing patient needs, coordinating care, and providing direct nursing care. Applicants... ...Program, and hold a valid Pennsylvania RN license. #J-18808-Ljbffr GeisingerNight shift$68.07k - $69.11k
...integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms, and a level 1 trauma...Immediate startNight shift$2,706 per week
...Registered Nurse (RN) | Ambulatory Care Location: New York City, NY Agency: Prime Staffing... ...: Patient assessment, triage, care coordination, EMR documentation skills... ...clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing...Permanent employmentFull timeContract workTemporary workShift work- ...Critical Thinking, Multitasking? Then the PTC RN Coordinator Role is for you! This position provides comprehensive care coordination for patients as assigned, including... ...patient admissions and continued stay, utilizing standard criteria. Facilitates patient throughput...Temporary workPart timeWork experience placementWork at officeLocal areaImmediate startFlexible hoursAfternoon shift
- ...seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our remote healthcare team. In this role, you will conduct inpatient and outpatient utilization reviews, support transitions of care, and ensure compliance with Medicare Advantage...Remote job
- Currently seeking a Utilization Management RN . Please see details and qualifications... ...medical necessity for inpatient and outpatient services. You... ...medical records, validate care plans, and authorize services... ...providers, support care coordination, ensure regulatory compliance...Immediate startRemote workWeekend workDay shift
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