CWOCN Utilization Nurse - Home Health UM
Integrated Home Care Services, Inc.
Integrated Home Care Services, Inc. is seeking a Utilization Management Nurse, CWOCN to ensure quality home health care services are delivered effectively. The role includes reviewing and auditing patient treatment files, ensuring compliance with regulations, and coordinating care with a healthcare team. The ideal candidate must have CWOCN certification, state licensure as an LPN or RN, and at least 2 years of experience in Utilization Management. Join our dedicated team to enhance care quality for our patients across New York. #J-18808-Ljbffr Integrated Home Care Services, Inc.
- ...Primary Duties and Responsibilities The Utilization Nurse utilizes clinical expertise, discretion,... ...based Inpatient Care Guidelines. The UM Nurse will also be responsible for assisting... ...Investigation and the efficient use of health care services consistent with the...Suggested
$29.1 - $62.32 per hour
...UM Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience.... ...person, one family and one community at a time. Utilization Management is a 24/7 operation and work schedule may...Work from homeHourly payFull timeTemporary workWork at officeRemote workMonday to FridayAfternoon shift- ...Remote is seeking a Utilization Management Nurse Consultant to work fully from home. This role involves assessing healthcare services, coordinating care, and ensuring effective benefit utilization for members. Candidates must possess at least three years of nursing experience...Work from homeFull timeRemote work
- ...Clinical Manager of Utilization Management The Clinical Manager of the Utilization Management (UM) Department oversees the daily operations of the UM team. This position manages the Utilization Review Staff and ensures compliance with regulatory requirements related...SuggestedLocal areaImmediate startWeekend work
- ...internship that supports the goal to put health first? The DOW SkillBridge... ...programs. Internship Details The Utilization Management Behavioral Health Registered Nurse (RN) Intern will report to a... ...Workstyle and Location Remote work at home. Must reside in a state that...Work from homeApprenticeshipInternshipRemote workHome officeWeekday work
- ...Summary Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership - experience - and creative... ...with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance...Permanent employmentTemporary workLocal areaImmediate startRemote workRelocation packageFlexible hours
$85k - $105.34k
...Umpqua-Health seeks a Utilization Review Nurse to evaluate clinical service requests and ensure quality care. This role includes conducting prior authorizations, collaborating with healthcare teams, and ensuring compliance with regulations. The ideal candidate will have...Remote work$34 - $47 per hour
...UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey... ...$34.00 - $47.00 / hour Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services...Hourly payFull timeLive inWork at officeRemote workMonday to FridayShift work- ...licensed professional a Registered Nurse preferred that is expected to... ...of the Precert / Outpatient UM team and works under the... ...demonstrate sound clinical and health plan business knowledge in their... ...and support needed to perform utilization management, medical necessity...
$29.1 - $62.32 per hour
We’re building a world of health around every individual — shaping a more connected, convenient... ...one family and one community at a time. Utilization Management is a 24/7 operation and work... ...weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule:...Work from homeHourly payFull timeTemporary workWork experience placementWork at officeLocal areaRemote workMonday to FridayAfternoon shift- ...healthcare affordable, improve the health of patients, and restore the... ...through precise and timely Utilization Review. In this role, you... ...growth aligned with Illinois nursing regulations and contemporary... ...to you include: Work from Home: Guidehealth is a fully remote...Work from homeBi-weekly payFull timeTemporary workFor contractorsLocal areaRemote work
- ...Graduate of a school of professional nursing approved by the appropriate... ...Experience: Interqual - Utilization Management - ICU or ED Physical... ...Must complete annual Employee Health requirements - such as annual... ...timely Utilization Management (UM) reviews across Medicine - Surgery...Permanent employmentTemporary workImmediate startRemote workRelocation packageFlexible hoursShift work
- MedPOINT Management is hiring a UM Outpatient Licensed Clinician in Los Angeles, California. In this role, you'll be responsible... ...current California RN or LVN license and 2+ years of experience in utilization management are required. Proficiency in Microsoft Office is...Work at office
$60k
...service and post-service utilization reviews and appeals for... ...an NCQA-compliant UM program. Salary: $60... ...SKILLS/ABILITIES The UM Nurse’s responsibilities... ...InterQual, CMS guidelines, health plan medical policies,... ...reimagining access to in-home healthcare. We connect...Temporary workLocal areaRemote work- ...Floating Expectation: No • Ratios: 1:40 • Years of experience REQ: 3-year acute medical Care Manager/UM experience performing utilization review in a hospital setting (not health plan/medical group) • First-timers accepted: Seasoned traveler is required Hardstop • Weekend...Immediate startShift workWeekend work
- ...Consulting Firm is seeking an experienced Registered Nurse (RN) specializing in Utilization Management (UM) and Utilization Review (UR) to join the team of one... ...check/security clearance. Benefits ~ Health Care Plan (Medical, Dental & Vision) Retirement...Temporary workMonday to Friday
- ...RN - Utilization Management RN - Utilization Management needed at Mountain Home Air Force Base in Mountain Home, Idaho. Duties include... ...according to appropriate health plan. If unsure, coordinates... ...Regional Office Clinical Liaison Nurse or reviews TRICARE Operations...Work from homeFor contractorsWork at officeLocal areaMonday to Friday
$19.47 - $38.08 per hour
...to invent the future of health care, here's your... ...general direction of the Utilization Management Manager, you... ...nationally recognized UM criteria. If you are... ...flexibility to work from home and in the office in this... ...accredited Licensed Vocational Nurse program ~ Active,...Work from homeHourly payMinimum wageWork experience placementWork at officeLocal area- ...all activities associated with El Paso Health’s (EPH) inpatient Utilization Review Unit. Ensures the Utilization... ...Ensures the Utilization Management (UM) unit’s compliance with all regulatory... ...years of experience as a Registered Nurse required, preferably in a clinical setting...Work experience placementFlexible hours
$74.16 - $107.75 per hour
...Description The Utilization Management (UM) Nurse supports appropriate levelofcare determination, patient flow, and revenue cycle integrity across... ...documentation accurately and timely in the electronic health record. Participates in quality improvement initiatives...Work at office- We’re seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you’ll perform both inpatient and outpatient utilization reviews while supporting transitions of care and ensuring patients receive...Remote work
- ...by connecting individuals with vital health resources through a compassionate workforce... ...you achieve your goals.JOB PURPOSEThe Utilization Management Nurse performs comprehensive clinical... ...review, special review requests, and UM pre-certifications and appeals, utilizing...Contract workWork at officeImmediate startNight shift
- ...Utilization Management Nurse Job Title: Utilization Management Nurse Reports To: Manager of Utilization... ...perform the Utilization Management (UM) services for SIHO (and affiliated business... ...'s primary role is to ensure that health care services are administered with quality...Full timeWork at office
$46.3 - $91.32 per hour
...Description The Utilization Review (UR) Nurse has a strong clinical background blended... ...in Utilization Management (UM), medical necessity and... ...clinics and a full range of health and social services across Alaska... ...programs, and hospice and home care. Providence is...Minimum wageFull timeLocal areaShift work- ...Job Summary The Registered Nurse (RN) II is a professional caregiver... ...instrumentation, and other health care team members. Essential Responsibilities... ...by health care team members. Utilizes effective communication... .... Preferred Qualifications CWOCN or CWCN certification...
- ...SUMMARY: We are currently seeking a Staff Nurse to join our Utilization Management department for the/Emergency Department / This position is a 0.6... .... Education: Attains and maintains current knowledge in UR/UM practices, payer requirements, clinical guidelines, and regulations...Shift workWeekend workAfternoon shift
$71.1k - $97.8k
...Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate care while working from home. Ideal candidates will be licensed RNs with a minimum of two years...Work from homeRemote work- ...SUMMARY: We are currently seeking a Staff Nurse to join our Utilization Management department for the... ...and reimbursement to optimize patient health outcomes and reduce unnecessary utilization... ...and maintains current knowledge in UR/UM practices, payer requirements, clinical...Shift workWeekend workAfternoon shift
- ...Astrana 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...Live inRemote workShift work
$34 - $55 per hour
...Utilization Management Nurse (RN) - Part Time Part Time - Day shift (8a-4:30pm), HYBRID role (Work both in Annapolis & at home) weekend/holiday rotation. Will work 56 hours every 2 weeks. FLSA... ...Americans with Disabilities Act. Pay Range $34 $55 USD Luminis HealthWork from homeHourly payPart timeDay shift
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