UM Review Nurse
Astrana Health
Utilization Review NurseAstrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans. This is a remote position for CA-licensed nurses. Candidates must live in California.We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting.Our Values:Put Patients FirstEmpower Entrepreneurial Provider and Care TeamsOperate with Integrity & ExcellenceBe InnovativeWork As One Team
$34 - $47 per hour
...Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you... ...LVN license in CA. At least 1 years of outpatient UM experience Experience with Microsoft applications such as Word...SuggestedHourly payLive inWork at officeRemote workMonday to FridayShift work- ...Provides support for clinical member services review assessment processes. Responsible for... ...model. Adheres to utilization management (UM) policies and procedures. Required... ...relevant education and experience. Registered Nurse (RN). License must be active and...SuggestedRemote jobWork at office
- ...Description Job Description Position Summary The PACE Utilization Review Specialist – RN oversees clinical utilization management for... ...Minimum Qualifications Graduate of an accredited school of nursing with a current unencumbered Registered Nurse license in the...SuggestedWork at office
- ...Job Description Job Description UM Audit & Compliance Nurse (LVN/RN) – MSO/IPA - HYBRID Location: Pasadena, California Industry: Healthcare... ...oversight, annual audits, focused audits, and compliance reviews related to Utilization Management. Serve as the...SuggestedPart time
- 1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating... ...Hospital Experience!! The Emergency Prospective Review (EPR) Nurse - RN has the responsibility to conduct a review of all patients...SuggestedCasual workWeekend work
$88.85k
...communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically necessary,...Full time$30 - $34 per hour
...A health services company is seeking a Utilization Management Review Nurse in Monterey Park, CA. This hybrid role includes conducting reviews for inpatient admissions and outpatient procedures, ensuring compliance with regulations, and working collaboratively with the...Hourly payWeekend work- ...Description Job Description JOB DESCRIPTION JOB TITLE: Director, UM - RN FLSA STATUS: Exempt DEPARTMENT: Utilization Management... ...of clinical practice. 2. Assigns work schedules, delegates reviews, provides direction on review priorities, meets the demands of...
$31.93 per hour
...just a job; it's a calling that drives us forward every day. Job Overview The LVN Utilization Management Nurse (UM Nurse) will provide routine review of authorization requests from all lines of business using respective national/state, health plan, and nationally...Hourly payFlexible hours$145.69k - $218.07k
...NURSE-MIDWIFE (Certified Nurse-Midwife) Print ( Apply NURSE-MIDWIFE (Certified Nurse-Midwife) Salary $145,687.20 - $218... ...physician. Essential Job Functions What You'll Be Doing: Reviews the patient's chart and searches for abnormalities that would...Full timeWork experience placementShift workNight shiftWeekend workAfternoon shift$145.69k - $218.07k
...Nurse-Midwife Salary: $145,687.20 - $218,074.56 Annually Location: Los Angeles County, CA Job Type: Full time Job Number:... ...requires referral to a physician. What You'll Be Doing: Reviews the patient's chart and searches for abnormalities that would indicate...Full timeNight shiftWeekend workAfternoon shift$125k
...under the supervision of a physician Provide consults to requesting physicians Maintain timely, accurate medical and billing records; review billings under your name/provider number and flag errors Supervise and review care rendered by non-PA staff involved in direct...Full timeMonday to FridayWeekend workAfternoon shift$45 - $57 per hour
...receive a text message to schedule your interview. Registered Nurse (RN) at Starling Oncology At Starling Oncology, you... ...records your responses and may use automated tools to support the review of job-related skills. These tools do not make final hiring...Hourly payFull timeTemporary workMonday to FridayShift work$145.4k - $174.48k
...from acute or long-term settings Assist in maintaining participant care in skilled nursing facilities and residences, making regular visits as dictated by participant need Review outcomes and utilization data, including hospitalizations and use of specialists, to...Night shift- ...SUMMARY: Responsible for the delivery of patient care through the nursing process of assessment, diagnosing, planning, implementation and... ...& re-assessments of patient care needs, based on hart review and/or direct observation. Documents care on patients according...
- ...care for all age patients in operating room. Provides care within nursing standards of practice and the policies of the Center. Makes... ...effectively with other disciplines as appropriate.Participate in quality review and performance improvement projects.Participate in the...Immediate startFlexible hours
- ...development, implementation and outcomes evaluation of a plan for nursing care provided by the nursing team. Provides technical nursing... ...other disciplines as applicable. Participate in quality review and performance improvement projects. Participate in the performance...Immediate startShift work
$2,800 per month
...Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty Utilization Review Job ID 18027156 Job Title Utilization Review RN Weekly Pay...Weekly payShift work- ...POSITION SUMMARY The Assistant Nurse Manager is a skilled and experienced professional Registered Nurse (RN) responsible for excellence... ...as needed. • Participates in hiring process, which may include: review applications; interviews applicants (potential staff members)...Work at officeShift workNight shiftDay shift
$246k - $267k
...health prevention and screening as needed - Participates in chart review and quality assurance activities as detailed in the Quality... ...Assurance policies and procedures - Supervises physician assistants, nurse practitioners, resident physicians, and students - EMR: Epic -...Weekly payFull timeImmediate start- Milton Hershey School, a cost-free residential school for pre-K-12 students, seeks compassionate Residential Youth Caregivers to support students’ daily home life. In this role, you’ll create a safe, nurturing environment, supervise routines, assist with homework, teach...
$46.92k
Description: Located in Hershey, PA, Milton Hershey School (MHS) is a top-notch home and school where over 2,200 pre-K through 12th grade students from disadvantaged backgrounds are provided an extraordinary, cost-free, career-focused education. This is made possible ...Full timeRelocationRelocation packageFlexible hoursWeekday work- ...Responsible for the delivery of patient care through the nursing process of assessment, diagnosing, planning, implementation and evaluation... ...standards of practice. Adaptive Care Planning Develop, review, and revise individualized plans of care every 24 hours or as patient...Immediate startShift work
$145k - $170k
...Nurse Practitioner - Cardiology Department: Providers Employment Type: Full Time Location: 506 W. Valley Blvd. Unit #100, San Gabriel... ...and clinic policies. Quality & Compliance Participate in chart reviews, quality assurance activities, and performance evaluations. Adhere...Full timeLocal area- ...NurseResponsible for the delivery of patient care through the nursing process of assessment, diagnosing, planning, implementation and... ...assessments & re-assessments of patient care needs, based on hart review and/or direct observation.Documents care on patients according...
$25 - $29 per hour
...therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training... ...clinical application in an accurate and timely manner. Review treatment sheets for completeness, ensure nursing signatures are...Hourly payWork experience placementImmediate startShift work- ...etc... # Handles patient grievances according to FHCCGLA's Policy & Procedure. # Assists in developing, updates & reviews of FHCCGLA Policies & Procedures (P&P's) as needed (with input from all other key personnel). # Ensures HIPAA compliance by maintaining...Daily paidFull timeTemporary workPart timeLocal areaAfternoon shift
$25 - $30 per hour
...therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training... ...clinical application in an accurate and timely manner. Review treatment sheets for completeness, ensure nursing signatures are...Hourly payWork experience placementImmediate startShift work- ...Nurse Manager Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures... .... Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across...Local area
$23 - $24.45 per hour
...Join an award-winning team of dedicated professionals committed to compassion, quality, and service! Responsibilities The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives....Full timePart timeWork experience placementWork at officeLocal areaShift work
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