Utilization Review RN: Medical Necessity & Care Level
The University of Texas Southwestern Medical Center
UT Southwestern Medical Center seeks a Registered Nurse for medical necessity Utilization Review in our Dallas facility. The role involves reviewing admissions, using evidence-based criteria, and advising on level of care with physicians and care teams. The ideal candidate has an active Texas RN license, 5 years of experience including clinical and utilization review, and familiarity with Epic CCM. Join a reputable academic medical center with strong benefits. #J-18808-Ljbffr The University of Texas Southwestern Medical Center
- ...Position Summary: The RN Integrated Care Coordinator (UM)... ...required to address utilization review cases. Roles and... ...of cases involving medical decisions and quality... ...support the medical necessity review process and plan... ...including basic level CPT/ICD10, authorizations...SuggestedLive inRemote workFlexible hoursWeekday work
- Job Category : Managed Care Requisition Number : RNMAN0359... ...Description Hiring Now for RN Utilization Review Coordinator Department: Case... ...patient status, medical necessity, and compliance with hospital... ...necessity and appropriate level of care throughout the episode...SuggestedFull timeLocal areaShift work
- Job Title With level of care screening criteria such as MCG or Interqual, CMS regulations as related to hospital admissions, utilization management or utilization review, and interfacing with health care payers/regulatory agencies.Suggested
- ...Job Details - With level of care screening criteria such as MCG or Interqual... ...related to hospital admissions, Utilization management or utilization review, and interfacing with health care... ...to enjoy, including: ~ Medical, dental and vision benefits ~ Earned...SuggestedTemporary work
- ...Description Summary: The RN Navigator Home Health Review plays a crucial role in... ...member of the patient’s care team, the RN Navigator... ...(Plan of Care) based on Medical Necessity guidelines and Homebound... ...discharge from service. Utilizes MCG Guidelines for post-acute...SuggestedFull timeWork at officeMonday to Friday
- ...Order Pharmacies, Medical Billing Centers,... ...Responsibilities: Conducts utilization management... ...certification reviews, facilitates the... ...determine appropriate level of care for utilization... ...for medical necessity (referring cases... ...! Qualifications RN License in NY with...Hourly payCasual workPrivate practiceWork at officeImmediate startMonday to Friday
$65 per hour
...RN Case Manager / Utilization Review - Syracuse, NY (#25268) Location: Acute Care/Academic Medical Center, Syracuse, NY Employment Type: Full-time Hourly Rate: $65/... ...utilization reviews for appropriate care level/coverage Coordinate discharge...Hourly payFull timePrivate practiceMonday to FridayDay shift- ...of Texas Southwestern Medical Center in Dallas is seeking a PRN Utilization Review Nurse to conduct medical necessity reviews for acute care. You will use evidence-... ...guidelines to recommend levels of care, serve as a resource... ...with an active Texas RN license and at least 5...Relief
- A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Remote jobFull time
- ...are seeking a PRN RN to join our team!... ..., and directs home care services. Successful... ...Responsible for continuous review of all aspects of... ...: appropriate utilization of services; ensuring... ...in the medical record; maintenance... ...Admits to appropriate level of service/ care....Part timeReliefWork at officeLocal area
$41 - $46 per hour
...Registered Nurse (RN) is a vital member... ...compassionate, evidence-based care in alignment with... .... By integrating medical and behavioral... ...readiness for the next level of care.... ...treatment team to review patient care, needs... ...Provide assistance to Utilization Review in communicating...Full timeReliefShift workNight shiftRotating shiftDay shift- ...Join our brand-new 56-bed Medical/Surgical Unit opening... ..., Patient-Centered Care to a diverse medical,... ...population with varying acuity levels. With dedicated and... ...Primary Purpose The RN is a licensed... ...patient's response. The RN utilizes knowledge of patient needs...Temporary workRelocation packageShift work
- ...efficient, cost effective care management process... ...financial and medical eligibility, medical necessity, and by developing,... ...set related to utilization review, care coordination,... ...have current, valid RN license or temporary... ...to appropriate next level of care. Communicates...Full timeTemporary workShift workAfternoon shift
- ...A Registered Nurse (RN) with 2 years of experience... ...to coordinate patient care delivery, that focuses... ...'s response. The RN utilizes knowledge of patient needs... ...trauma informed medical forensic examination to... ...Participates in SANE Peer Review and quality assurance /...Full timeTemporary workTraineeshipWork at officeNight shift
$2,248 - $2,468 per week
...Utilization Review Registered Nurse Supplemental Health Care is connecting Utilization Review Registered Nurses with top-tier hospital contracts in Syracuse,... ...hours per week What We Offer: ~ Full medical, dental, vision, life, and even pet insurance!...Weekly payFull timeContract workLocal areaShift work$37 - $39 per hour
...that goes beyond bedside care. Collaborate with... ...being of patients through medical device technology. You... ...pulling pumps as needed. Utilize clinical nursing expertise... ...required. RN license required. Excellent... ...will be subject to a review of their driving record...Hourly payExtra incomeFull timePart timeSeasonal workImmediate startWorldwide- ...RN Case Manager The RN Case Manager in this... ...the clinical plan of care to conform to evidence... ...integrates care coordination, utilization management, and... ...include medical necessity screening, care coordination... ...in weekly Complex Case Review, arranging for post-discharge...Work at office
- ...leader of the Patient Care Team and that member of... ...interdisciplinary plan of care. Reviews information on all... ...Monitors the type and level of team services provided (staffing, medications, HME, supplies, level... ...program review. Performs utilization review of continuous...Contract workLocal area
$8k
...seeking a Registered Nurse (RN)to work on aFull-... ...taking vitals, passings medications, and identifying and acute... ...orders for patient care. Communicate with supervisor... ..., recommend, and review medical policies and... ...candidate's education level and experience relevant...Hourly payFull timeTemporary workLocal areaShift workDay shift$31.48 - $44.43 per hour
...seeking a Registered Nurse (RN)to work on aPer Diem... ...vitals, passings medications, and identifying and acute... ...medical orders for patient care. Communicate with... ...Develop, recommend, and review medical policies and... ...candidate's education level and experience relevant...Hourly payDaily paidShift work- ...the hemodialysis health care team as a Registered... ...related to diet/fluid and medication compliance.· Provides... ...Sheet.Laboratory-related:· Reviews, transcribes, and... ...correct labs tubes are utilized for prescribed lab specimens... ...and moderate noise levels. May be exposed to infectious...Full timeTemporary workReliefImmediate startFlexible hoursShift work
$2,018 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Dallas, TX Agency: Revolution Healthcare... ...per schedule)- Ability to float to Medical/Surgical and Progressive Care units**... ...our partners with the highest level of respect and professionalism. Our mission...Permanent employmentFull timeContract workReliefLocal areaImmediate startShift workNight shiftRotating shift$1,646 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Dallas, TX Agency: Advantis Medical Staffing Pay: $1,646 per week Shift Information: Nights - 3 days... ...and pair that with personalized concierge-level service from our expert recruiters. You can choose...Full timeContract workImmediate startShift workNight shift$144k
...North Texas Health Care System (VANTHCS) in... ...for care including medication equipment-assisted... ...deviations from normal to RN or MD/DO.... ...ability to appropriately utilize this knowledge in... ...clearly demonstrate the level of competence... ...closer higher-level review. GS-06 - Completion...Permanent employmentFull timePart timeWork experience placementSeasonal workLocal areaRemote workTrial periodRelocation packageMonday to Friday$1,647 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Irving, TX Agency: Advantis Medical Staffing Pay: $1,647 per week Shift Information: Nights - 3 days... ...and pair that with personalized concierge-level service from our expert recruiters. You can choose...Full timeContract workImmediate startShift workNight shift$2,267 per week
...Registered Nurse (RN) | Cardiovascular Unit Location... ...TX Agency: Magnet Medical Pay: $2,267 per... ...specializes in the care of patients with cardiovascular... ...infarction. Utilize advanced monitoring equipment... ...pressure, and oxygen levels. Track changes in...Full timeContract workImmediate startFlexible hoursShift work- ...is the specialty care platform connecting... ...Care Specialist (RN or LVN) The Infusion... ...timely access to medically necessary infusion... ...service-level expectations. Monitor... ...quality assurance reviews, call audits, and... ...care management, utilization management, or a related...Temporary workWork at office
- Elevance Health is seeking a Wound Care Utilization Management RN to perform pre-certification and authorization for Home Health Services for members with wound care needs. You will review records, coordinate with physicians and home health agencies, and ensure appropriate...Remote jobMonday to FridayShift work
- ...compassion. As a world-renowned medical and research center, we... ...the best possible care, resources, and... .... Experience 1 year of RN experience. Licenses and... ...stated medical plan of care utilizing the nursing process to... ...seminars to continue level of competency and ensure...Full timeWork at office
$1,875 per week
...Registered Nurse (RN) | Medical Intensive Care Unit Location: Dallas, TX Agency: Revolution Healthcare... ...on patient acuity and clinical skill level Full range of ICU equipment... ...a skilled interdisciplinary team utilizing state-of-the-art technology and equipment...Full timeContract workTemporary workShift workNight shiftWeekend work
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